HFMA staff discuss the biggest healthcare news stories of the year

Erika Grotto: The best healthcare finance content of 2022, today on HFMA’s Voices in Healthcare Finance podcast. Hello, and welcome to the podcast. I’m your host, Erika Grotto. Today, I’ve invited some special guests to talk about the best content HFMA has produced this year. We’ve got the entire editorial staff, plus a few others. First up, a wrap-up of the year’s top news stories with HFMA Senior Editor Nick Hut and HFMA Policy Director Shawn Stack.

Nick Hut: Hello, everybody. As part of this 2022 year-end special, we’re reviewing a few of the big healthcare policies and trends for the year. Shawn, I think the big story this year for our listeners and HFMA members is quite simply that the financial deterioration that we saw over the previous couple of years not only was not alleviated like we hoped it might be but actually was exacerbated. We’ve talked about this downswing before on the podcast, but by way of review, how tough of an environment is it right now?

Shawn Stack: Yeah, Nick. It’s still pretty tight. You know, wages and labor have somehow gotten under control, but they’re still very high for hospitals and organizations. Reimbursement is scarce as we come into the new year, as you know, and as we talked about before with the reimbursement updates or Medicare although sometimes, you know, on the inpatient side, maybe record breaking for the last several years but still not keeping up with inflation. Ability to pivot service lines that are losing money and get healthcare professionals to get their arms around that piece has been a challenge because you not only have reimbursement issues, high cost, high labor, high real estate, leases, you also have disruption coming into the market more than ever in healthcare and scraping off the cream, right, the patients who can pay for care. So it is very challenging and continues to be very challenging for small and large organizations.

Hut: No doubt. And we’re going to get to trends in disruption for the past year in just a moment, but it also needs to be said that operationally speaking, hospitals are having a really tough time with discharges and with throughput from the emergency department since mid-2020 when we were a few months into the pandemic. Hospitals have had to report on their capacity, and early December marked only the second time since then that nationwide capacity is past the 80% mark. The other time was in January of this year, right around the peak of the initial omicron variant. So we’ve got this so-called “tripledemic” of viruses, and with that onslaught, it just seems like front-line clinicians can’t catch a break, and the reverberations for the work force will be felt for some time.

Stack: That’s right, Nick, and lengths of stay of course, as you hinted at, are up because the post-acute setting is even in worse dire straits than the hospitals, with funding, with staffing, and hospitals can’t get their patients released to post-acute care facilities because they don’t have the bandwidth to take on the patients.

Hut: Absolutely. It’s a really tough situation, and we’ll just have to see the strategies and tactics that industry leaders implement to try to mitigate these concerns to some degree. Moving on to healthcare industry disruption in the year 2022, you know, in the past year, we did an hour-long webinar and two full podcast episodes on that topic, but Shawn, to review, what is there to say about the trends we saw in disruption, including the implications for value-based care?

Stack: Right. I mean, CMMI has been very busy reevaluating and restructuring their value-based models, really trying to focus on making them more meaningful as far as quality outcomes, cost savings and simplicity in implementing those with providers so they don’t have such a heavy lift in administrative burden launching the value-based care programs. We have seen in 2022 private equity continuing to dump money into digital health venture funding. I think we’re at $2.2 billion the last quarter that I looked at, the third quarter. So not as hectic as 2021 but still very hectic in digital health venture funding. And then, of course, just the single new entrants to the healthcare market. We’re waiting to hear, the Amazon purchase of One Medical being approved soon. Mark Cuban, although not really hospital centric but more pharmaceutical industry centric, Mark Cuban just announced that he’s going to be focusing on an online pharmacy. He’s made a huge dent in the market, in the pharmacy market, so lots of disruption still coming into play here, even ending the year and looking into 2023.

Grotto: When it comes to HFMA greatest hits, there’s none greater than our Healthcare 2030 series. There were four reports in 2021, four in 2022, and there are more to come next year. We’ve also had podcast episodes and Annual Conference sessions around the topics covered in this series. Here’s HFMA’s Brad Dennison with more.

Brad Dennison: This is Brad Dennison, HFMA’s director of content, along with Paul Barr, one of our senior editors here at HFMA. Welcome, Paul.

Paul Barr: Hi, Brad. Thanks.

Dennison: So we’re here to talk about Healthcare 2030. It’s a series of four reports that started in 2021, and it was such a big hit that we decided to do it again, another volume, four more reports in 2022. I remember we were both at the Annual Conference back in June, and we had a Healthcare 2030 session that was standing room only. It was phenomenal. So it’s good to have the series back for four fresh new reports, and I can tell you this: The analytics on this continue to go gangbusters. It’s been downloaded 25,000 times, and it’s sort of rejuvenated interest in the series that we did last year, so it’s been a big hit and I think one of our favorite things that we do here at HFMA. So Volume 2 was introduced in September, and that was “Restoring Trust in Healthcare,” and that really came from our various listening posts at HFMA where we were hearing this pop up as an issue, but Paul, if you could talk a little bit about the “Restoring Trust in Healthcare Report,” tell us more about that.

Barr: We knew that this was a topic that was on a lot of people’s minds, but it’s not necessarily something that industry executives were eager to talk about. But our writer Jeni Williams was able to get some sources that tell the story of how trust was declining as a result of a number of different things, mostly driven by the pandemic but also by societal factors. Part 2 was covering the next generation public health system, which is sort of an extension of the restoring trust theme. It involved the roles that hospitals should and do play in public health and how that really needs to be restructured in order to be effective. Part 3 is one that I’m particularly proud of because it really dissects the inherent structure of the healthcare system to figure out, can value-based care be provided if the provider is not also the payer. That question is still open, but Part 3 really dives into that topic. And then the last one is about reimagining the patient-caregiver relationship and trying to figure out what is the best way to provide care for the patient and for the name of efficiency.

Dennison: Thanks for that overview, Paul, and there’s more 2030 content to look forward to in the months ahead. We’re going to have a podcast dedicated to Healthcare 2030. We’re going to have another session at the AC in June in Nashville that you don’t want to miss, and we’re also bringing back another four reports with Volume 3. That’s in development now. And I’d be remiss if I didn’t thank the sponsors that made this work possible. That includes the Chartis Group, FORVIS, Xtend Healthcare and Bank of America. We’re appreciative as always to them. So thank you, Paul, for joining me today.

Barr: Thank you.

Grotto: Next, we’re going to talk about HFMA’s flagship member publication, hfm magazine. If you’re a member, you get this every month. You can certainly read the content online as well. So here to talk about some of the key content from this year is the managing editor of hfm, Eric Reese. Hi, Eric.

Eric Reese: Hi, Erika. It’s great to be here.

Grotto: So tell me, what has been really hot in hfm this year?

Reese: One of the things that’s most noteworthy has been hfm’s focus on how finance leaders can play a central role in helping to improve value and then to address problems of health inequity and promote cost effectiveness of health for all Americans. But you know, I will have to add that in focusing on that topic, we’re always keeping in sight the pivotal importance of ensuring that whatever strategy somebody is using to address those considerations, those strategies are also financially sustainable and contribute strongly to the future well being and growth of the healthcare enterprise. So here’s just a few examples of what I’m talking about. The February issue, for example, we actually tackled the issue of cost effectiveness of health straight on. The title of that publication was, “A just cause: HFMA’s CEOH initiative addresses the factors that impede quality of health and raise healthcare costs.” We examined in that article the challenge of promoting CEOH, and the goal was to develop a system for care that is needed, accessible and affordable.

Grotto: Cost effectiveness of health is something that is really woven into so much of what we do at HFMA and really woven into our content, whether we sort of say so out loud or not. Tell me a little bit more about what else has been big in hfm this year.

Reese: In March, we examined the impact of Covid-19 on hospitals’ and health systems’ revenue cycle staffing. The article was called “Revenue cycle staff shortages push leaders to adapt quickly.” And then in April, we extended that conversation to clinical staffing with our cover story, “How to future-proof your travel nurse and clinician staffing.” You know, it’s maybe oblique to cost effectiveness, but maintaining a happy and effective staff, if you don’t have that, you’re not going to get anywhere with anything else. More germane to CEOH in particular, the summer issue, we looked at the future of telehealth and virtual healthcare and specifically how it will play a role in promoting CEOH. We had November—this one, I think was particularly significant—cover feature was titled, “Healthcare cybersecurity stakes reach alarming levels,” and that’s a particularly urgent issue that we felt absolutely needed to be addressed given that there’s been a huge increase in risk and consequences of cyberattacks on our nation’s healthcare system, to the point that they’ve actually noted that cyberattacks have resulted in patient death. So we felt that this is a very critical issue for healthcare organizations to put on their high priority list. And then lastly, the December issue advanced the theme of social responsibility with hospitals’ work to make the supply chain green, and that article explores how the nation’s hospitals can make their operations more environmentally sustainable, once again contributing to sort of a larger social goal. And that’s just a quick snapshot.

Grotto: A lot of hot topics in there, a lot of really important things that our members are looking to learn about. So looking forward to seeing what makes it into hfm in 2023. Well, thank you so much, Eric, for joining me today.

Reese: It’s my pleasure, Erika. Thank you so much.

Grotto: Now I would like to welcome Crystal Milazzo, who is another one of our senior editors here at HFMA. One of the most popular pieces of content in hfm every month is Jill Geisler’s Leadership column, and Crystal is the editor who works with Jill to create this column every month, so I’ve invited Crystal on today to talk a little bit about some of the noteworthy columns from this year. Hi, Crystal.

Crystal Milazzo: Hi, Erika. Thanks for having me.

Grotto: So tell me which of Jill’s columns kind of had the biggest impact this year.

Milazzo: This past June, Jill had a column entitled “Lead like Zelenskyy,” and in it, she addressed the issue of crisis management and leading through tough times, but using that example that Ukraine’s Vladimir Zelenskyy was setting in the way that he was leading his country in the war against Russia, and it was kind of a “do like Zelenskyy does, not like the other leader is doing,” so it was kind of a nice compare and contrast. I also think it was really cool that I heard yesterday that Zelenskyy was named TIME magazine’s person of the year. So I feel like that was one that we did that was particularly timely. In November, Jill tackled the issue of the quiet quitter trend, which we heard a lot about in the late summer and throughout the fall. And she tackled it from the perspective of what leaders can do not only to prevent quiet quitting but she said that leaders need to acknowledge that they might actually be perpetuating it by things that they were doing, on the way that they were interacting with their staff. So she offered some really good helpful hints for leaders on how to make sure that they weren’t making the problem worse than it was. Probably my favorite timely one that Jill did this past spring was the topic on how inclusive leaders can protect against invisible work. It was a column on DEI-related efforts, but it was approaching it from a totally different perspective. For example, we know that many of today’s leaders—or at least we hope they are—are focused on creating and nurturing teams with diverse identities, backgrounds and experiences. And we also know that those leaders, in an effort to address those issues, often invite staffers, especially the ones who’ve been traditionally underrepresented into the planning, advising and execution of workplace DEI efforts. For example, they’re asked to serve on the diversity council. They’re asked to sit on other task forces as a representative of a DEI community. We ask them to do sensitivity reads of workplace materials. We ask them to translate all sorts of extra activities that come under that DEI-related heading. Unfortunately, what can happen is that in asking those people to serve in those roles, leaders can unknowingly place an unintended burden on those staff. They ask them to do invisible work, and that’s special assignments that are on top of regular responsibilities, but it isn’t rewarded or compensated. So Jill, in addition to just laying out the issue of invisible work, which I’m sure was an introduction to the topic to a lot of people, but she suggested things that leaders can do to avoid assigning such invisible work—things like rewarding DEI-related work and ensuring that it doesn’t get in the way of other advancement opportunities.

Grotto: I remember that column. I really liked that one too. Something that Jill does really well that I love is take something and say, “You might not realize that you do this.” She has a very kind manner, but she’s very good at kindly pointing out, “This might not look to other people the way you think it does.”

Milazzo: Yeah, that’s absolutely right. She has a knack for delivering maybe not the best news in a kind way, but then also turning it around and adding a positive spin to it, and I think that’s something that really resonates with people today.

Grotto: Yeah, and we know that HFMA members are really hungry for more leadership content, learning to be better leaders, whether they are leaders today or they want to be leaders in the future. And something that I’ve talked about with multiple guests on this podcast is that you don’t have to be the manager, you don’t have to be the boss to be a leader in your role. So there really is something for everyone in this column.

Milazzo: That’s absolutely right.

Grotto: Thank you so much, Crystal, for sharing these pieces with us. We will link all of them in the show notes, and anyone who wants to read Jill Geisler’s column, you can find it in hfm magazine and of course on our website, hfma.org. Thanks so much, Crystal.

Milazzo: Thank you, Erika.

Grotto: Next I would like to welcome, HFMA Senior Editor Deb Filipek. Deb curates three news stories every week for our Healthcare News of Note blog. Deb, this is content that’s regularly getting a lot of hits on our website. What makes you choose the stories that you do?

Deb Filipek: Hi, Erika. As you know, all HFMA editors keep tabs on news and trends in healthcare that are most relevant for healthcare finance professionals. But the stories I like to focus on are any that shed light on the cost effectiveness of health and studies on inequity in healthcare and what can be done to address the issue. I also tend to keep tabs on staffing shortages and fluctuations for nurses, physicians and other clinicians, mergers of large healthcare entities and the best of hospital and healthcare system listings and awards. Each blog is a synopsis of three stories in the news and is a 2-4 minute read. Of course, for more information, readers can always click on the links provided in the blog.

Grotto: And as far as links to the blog itself, we’re about to talk about a couple of specific blog posts, and we will include links in the show notes for anybody who wants to check those out. You definitely focus on a lot of things that we try to talk about on the podcast, so a lot of good, interesting stuff there. But Deb, when I asked you about the top stories for the year, there was one topic that clearly stood out, and that was Oracle’s acquisition of Cerner. So tell me about that.

Filipek: Yeah, exactly. The most popular piece for the year came out on August 26^th and was about how the Oracle-Cerner deal could change the healthcare industry. In it, I provided a synopsis of news coverage with one news source calling the deal “a seismic acquisition” and the Wall Street Journal quoted as saying the deal could address the major challenges in healthcare, data sets that cannot communicate with one another. Another really popular story about this merger was published March 1. That piece focused on ongoing anti-competition scrutiny, and then once the deal was finalized, we wrote about it on June 9 in our blog.

Grotto: What are some other topics that were popular on the blog this year?

Filipek: One of them discussed that 66 hospitals, out of more than 3,600, or less than 2%, earn top marks for social responsibility. That was according to a report by the loan institute. I think, like all people, our readers are curious to not only see how their healthcare organizations may have fared in these types of stories but to see how other hospitals and health systems may have ranked. No doubt the fact that social responsibility is on everyone’s radar these days helped too. The second one discussed how staffing shortages in hospitals and healthcare settings were seen as jeopardizing patient health. That report was by ECRI. I think when it comes to patient safety, everyone in healthcare understands the significance and was one reason this particular blog did well.

Grotto: Definitely a couple of other topics that are big ones of interest, clearly, if they’re getting that much attention on the blog, but good ones for us to keep looking at. So thank you, Deb, so much for coming on and talking about the news of note. Can you tell everybody where to find it on our website?

Filipek: Definitely. Thanks for having me as a guest, Erika. I’ll be reviewing these stories in a year-end wrap-up blog that members can access Dec. 30 on hfma.org.

Grotto: One HFMA benefit that has been great for members not only to get information and great content but to share ideas with each other has been our Community. And if you’re not active in our Community, then you definitely should be. Right now, I am excited to welcome Melanie Binder, the Community Manager for HFMA. Hi, Melanie.

Melanie Binder: Hi, Erika.

Grotto: So, we talk a little bit like this on occasion about what’s happening in the community. So tell me what’s new and exciting.

Binder: So one of the things that’s new and exciting is that we’ve recently launched a community group to support our international members. So if you haven’t checked that out, we do have a new forum for international members. There’s a lot of other ways to use the community to support the work that our members do. Some of it you may not see on all groups, but it’s a little bit behind the scenes. We do have some private groups that support our members who are taking some of our premium facilitated learning courses, or they are active members in our executive councils as well as with our Chapter leaders. We also recently launched a group to support our MAP app users. So if you’re a MAP app subscriber, this is the place you can learn about tips and tools for MAP app implementation. And also coming probably within the next couple of weeks or early 2023 will be a public group for MAP awards, and that again will be a group that any member can join or if they’re curious about the MAP awards share tips and tools and also best practices for applying for the award.

Grotto: We have some pretty active groups in the community now. What are some of the hot topics that people have been discussing?

Binder: So you know, one of the groups that we launched at the end of 2021 was for the No Surprises Act. That continues to be a really hot topic. We see a lot of activity in this group, and a lot of our members are using that group to ask for clarification, exchange resources as well as learn from each other as they navigate through the new regulations. Some other hot topics that we’ve seen in some of our other groups were payer scorecards, payer contracts, productivity standards, topics like medical necessity denials, even debt collections and insurance timely filing. We also saw some discussions posted about revenue code assignments and meeting contract rates, and there’s just a variety of topics that we’re seeing throughout a lot of our different community groups.

Grotto: Anything our members should be looking forward to in the coming year?

Binder: Yeah, well, we’re hoping we’re going to see a lot of new discussions started by our members. We’re also going to be launching some new groups, so please look for that coming in 2023. One of the things I mentioned was a group for our MAP awards. And then we just have some other ideas based off of feedback that we’ve received from our members about how they’d like to use the community, what kind of groups they think would be very helpful. So we’re in the process of formatting that. We’ll be launching these new groups throughout 2023, so stay tuned for more information about those groups as well.

Grotto: Sounds great. Well, thank you, Melanie, for joining me today.

Binder: Thank you, Erika.

Grotto: Voices in Healthcare Finance is a production of the Healthcare Financial Management Association and written and hosted by me, Erika Grotto. Sound editing is by Linda Chandler. Brad Dennison is the director of content. Our president and CEO is Joe Fifer. We’d love for you to rate, review and subscribe to our podcast, and of course, check the show notes for links to all the great content we’ve discussed here today. If there are topics you want to hear about in 2023, let us know. You can email our team at [email protected].