Maryland’s all-inclusive population health payment model continues to show promise, but nonhospital spending poses a concern
An innovative payment model for Maryland healthcare providers has improved utilization, cost and quality thus far, but an increase in nonhospital spending requires further study. The Center for Medicare & Medicaid Innovation (CMMI) released an analysis of the first three years of Maryland’s Total Cost of Care Model, an effort to improve population health management.…
News Briefs: Financial and operational pressures continue for hospitals amid scattered positive signs
Recent financial data for the hospital industry illustrate continuing challenges even as some trends improve. Fitch Ratings released an analysis in early March that offers scant reason for optimism. Titled “Early NFP hospital medians show expected deterioration; will worsen,” it draws on data from hospitals with earlier 2022 financial year-ends. Those numbers show “materially weaker…
How investing in the workforce can improve a health system’s bottom line
The year 2022 will be remembered as one of the worst financial years on record for healthcare. It will also be recalled as the year when the anticipated workforce shortage moved from being just one of many strategic concerns for health system leaders to becoming their most critical and urgent challenge. The rapidity with which…
Reports on patient safety indicate progress, challenges and a need to focus on pediatric mental health
Recent reports add context to the issue of patient safety in hospitals and health systems. ECRI released a report that ranks the pediatric mental health crisis as the No. 1 patient safety issue in healthcare. The report cites a JAMA study that found increases of 29% in anxiety and 27% in depression between 2016 and…
Creating sound strategies to manage compensation and benefits regardless of where your employees reside
No doubt there are significant cultural and financial benefits to supporting continued remote and hybrid work in healthcare, particularly in billing/coding, call center, scheduling and administrative roles. Healthcare, however, faces specific challenges as they seek to demystify multi-state tax rules.
Meeting healthcare’s workforce challenges requires innovation — with a dose of humanity
There is no low-hanging fruit left in workforce innovation. Yet hospital and health system finance executives who are looking for investments their organizations can make to reach higher up the tree should not be deterred. They can follow the lead of health systems that have already taken risk and reaped rewards — from taking an…
Member spotlight: Reaching out to learn and lead are hallmarks of Nimisha Madhu’s approach to revenue cycle management work
Nimisha Madhu enjoys exploring and learning about new areas in revenue cycle management (RCM) and then using her knowledge to deliver positive outcomes to her co-workers. Madhu, billing and recovery officer at Sheikh Shakhbout Medical City (SSMC) in Abu Dhabi, recently shared with HFMA’s International Update how she is using her HFMA international membership to…
Hospitals push back against a coordinated effort to revamp the 340B program
A lobbying fight has started over the future of the 340B Drug Pricing Program, with hospitals seeking to protect what they view as an essential source of cost savings. The advocacy group 340B Health and prominent hospital associations are seeking to repel an effort led by the Pharmaceutical Research and Manufacturers of America (PhRMA) to…
New guidance for No Surprises Act arbitration looks like an improvement for providers
Responding to a recent court ruling, the U.S. Department of Health and Human Services (HHS) has updated the application of criteria for deciding No Surprises Act (NSA) independent dispute resolution (IDR) cases. Certified IDR entities (i.e., arbitrators) received guidance March 17 instructing them to more directly consider multiple factors when deciding on an out-of-network payment…
How to determine appropriate patient status and navigate observation-level care
The financial implications of ensuring appropriate patient status throughout a hospital stay are substantial, so it is in organizations’ interest to enhance the process.