Clinical audits and denials impact 3% or more of NPR being held in reserve
This pulse survey shows how healthcare organizations are currently tracking health system’s audits and denials from government and commercial payers.
3 ways healthcare providers should vet potential private equity partners
As their medical practices returned to near-normal operations recently, more than two years after COVID-19 restrictions were first imposed by the Centers for Disease Control and Prevention (CDC), some practice owners found themselves taking stock of their livelihoods and future prospects. The pandemic caused many of them — including physician groups and health systems —…
News Briefs: TMA returns to court over concerns about the No Surprises Act’s arbitration process
The Texas Medical Association has gone to court for a second time in less than a year over the independent dispute resolution process that’s part of the No Surprises Act.
Why it can be a good idea for hospitals to stand up to government policy
Healthcare finance executives in the United States can take a lesson from an eye-opening book by Ted Giovanis, FHFMA, MBA, Beyond fear: How I fought the feds for six years — and won. In this book, Giovanis, a long-standing member of HFMA’s Maryland Chapter, chronicles how he identified an error in an arcane Medicare formula…
Healthcare’s cybersecurity stakes reach alarming levels
The threats to U.S. healthcare organizations from cyberattacks were already on the rise before COVID-19. But they have grown dramatically as a result of the pandemic. Major contributors to rising risk were the rush to respond to the need for telemedicine services and the shift of many staff to remote workplaces. “Hospitals had to stand…
Changes to reimbursement for 340B drugs reverberate in the 2023 final rule for Medicare outpatient payments
The Medicare payment rate for hospital outpatient services will increase significantly in 2023, but the net gain will be quite a bit less than is apparent at first glance.
How health systems can support underserved patients through in-home care
Finding a way to deliver high-touch care to vulnerable and underserved patients using the patient’s home as the primary point of care has become a strategic priority for providers. The strategic shift to a focus on in-home care for these populations stems from increasing pressure on health systems to lower the cost of care for populations they serve while solving for the challenges presented by social determinants of health.
Less can be more: New considerations for hospital and health system partnerships
A range of affiliation structures and contractual obligations that stop short of full integration can offer an attractive alternative for hospital and health system partnerships contending with difficult operating environments.
An HFMA poll shows CFOs want more collaboration with CIOs
This pulse survey shows that CFO’s need to be included on additional information about the risk assessment of IT spend, prioritization of major initiatives, alignment of corporate goals, expected ROI and more.
Telehealth is primed for growth despite post-lockdown fade
If our nation is to achieve true cost effectiveness of health, virtual healthcare must play a pivotal role. Here, two health system leaders share lessons learned from their efforts to develop effective telehealth programs as a key component in their long-term value-focused care strategies, and two thought leaders weigh in on keys to telehealth success.