Optimizing 340B participation compliantly while “waiting and watching” new developments
Since 1992, the 340B program has required drug manufacturers to provide eligible healthcare organizations and other covered entities with drugs to be used for these organizations’ outpatients at significantly reduced prices, with the intent of helping safety net organizations improve their financial stability. In turn, hospitals are expected to demonstrate that the savings they receive…
Hospital payments have been substantially affected by the Change Healthcare cyberattack, report finds
Newly published data reflect the extent of the payment loss experienced by hospitals and health systems during the first month or so after the Change Healthcare cyberattack. A report (registration required) published in mid-May by Strata finds that gaps in expected revenue ranged from 16.5% to 17.9% per hospital for Q1. The insights were culled…
HHS issues regulations to strengthen anti-discriminatory protections in healthcare
Healthcare providers should be aware of the compliance requirements in sweeping new federal regulations intended to improve health equity and reduce healthcare disparities. An HHS final rule expands upon Affordable Care Act (ACA) Section 1557 language that has prohibited discrimination on the basis of characteristics such as race, color, national origin (including English proficiency), age,…
Ascension systems remain down after cyberattack
Executives with Ascension health system, St. Louis, are keeping in contact with leading law enforcement agencies and industry organizations as they work to restore systems that were shuttered by a cyberattack. The apparent ransomware attack has led to a shutdown of different systems that will last for an undetermined period of time. The attack also…
Bridging the gap: Integrating value-based care into revenue cycle management
The idea of value-based care (VBC) has existed for decades but only gained momentum since the 2017 implementation of the Merit-based Incentive Payment System (MIPS) and the Quality Payment Program (QPP). VBC incentivizes providers for quality outcomes, unlike fee-for-service models that reimburse providers for each service performed. The ultimate goal of VBC is to improve…
Annual report on Medicare financing could reduce the immediate impetus to address longstanding issues
New data on the state of Medicare funding show short-term improvement while keeping the stakes high for ensuing decades. The annual report from Medicare’s trustees shows the Hospital Insurance Trust Fund (i.e., Medicare Part A) has enough money to keep beneficiaries covered and providers paid through 2036. That’s an increase of five years from the…
Closures of Walmart’s health centers reflect the widespread financial constraints in U.S. healthcare
Beyond signaling a setback for retail-based healthcare disruptors, Walmart’s recent decision to close its health centers is symptomatic of issues hampering the nation’s ecosystem for primary care, industry analysts say. The retail behemoth announced April 30 it would be closing all 51 of its health centers across five states, along with its virtual-health service. Five…
Congressional hearings on the Change Healthcare cyberattack bring attention to providers’ continuing predicament
Two congressional hearings involving the CEO of UnitedHealth Group offered few concrete solutions to the issues surrounding the Change Healthcare cyberattack but did highlight the ongoing pressures facing healthcare stakeholders. Andrew Witty, the CEO, was questioned May 1 by the Senate Finance Committee in the morning and a House subcommittee in the afternoon. For providers…
Seeking to improve healthcare for Medicaid beneficiaries, CMS issues a flurry of regulations
CMS over the last month published a trio of final rules intended to make the Medicaid program work better for beneficiaries, with implications for healthcare providers. The three rules address eligibility and enrollment, access and Medicaid managed care. Streamlining eligibility and enrollment The first rule addresses administrative barriers in an effort to simplify enrollment processes…
FTC challenge adds to the strain on the hospital-based anesthesiology workforce
A Federal Trade Commission (FTC) challenge to the purchase of a major anesthesia provider, after a rocky couple of years for anesthesia providers, has created an even murkier outlook for hospital-based anesthesia services. The FTC’s suit, filed in September against U.S. Anesthesia Partners, Inc. (USAP) and the private equity firm Welsh, Carson, Anderson & Stowe,…