Medicare outpatient payments to hospitals won’t rise considerably in 2024, according to a proposed rule
Medicare’s newly proposed outpatient payment update for 2024 is unlikely to be greeted with enthusiasm by hospitals. The update for items and services provided in the hospital outpatient or ambulatory surgical center setting would be 2.8%, mirroring the proposed change for inpatient payments. The base update would be 3%, with a statutorily required productivity adjustment…
4 opportunities to improve mid-cycle revenue operations
The quality of a hospital’s revenue cycle processes directly impacts the health of its bottom line. In an age of stagnant margins, hospitals should do all they can to improve revenue cycle efficiency. The mid-cycle—that critical phase between patient registration and claims submission — is a great place to start. Numerous challenges arise during this…
Billions of dollars in lump-sum payments are coming to hospitals as a remedy for 340B-related underpayments
Hospitals that participate in the 340B Drug Pricing Program stand to receive $9 billion in aggregate lump-sum payments as compensation for underpayments from Medicare during a nearly five-year period. In a proposed rule issued July 7, CMS described how it would provide remedies following a 2022 Supreme Court ruling that the U.S. Department of Health…
Annual Conference: Houston Methodist uses AI in virtual models for critical care, patient observation and more
Artificial intelligence (AI) is driving innovation in clinical operations at the Houston Methodist hospital system, as explained during a presentation this week at HFMA’s Annual Conference. Among other virtual-care programs developed by the organization’s innovation center, Houston Methodist has incorporated a virtual ICU and virtual observation in the inpatient setting. Both programs use AI to…
Annual Conference: How Mayo Clinic establishes the mindset and processes that foster innovation
Hospitals and health systems must adapt their practices using an innovator’s mindset to keep up with the change sweeping the industry, according to a presentation this week at HFMA’s Annual Conference. “Innovation, at this point in our industry’s landscape, is pretty critical,” said Praveen Mekala, enterprise division chair with Mayo Clinic, referring to the problems…
Annual Conference: For hospitals, effective chargemaster management can bolster revenue capture
Amid the changes and challenges buffeting the hospital and health system sector, chargemaster management remains a key step in protecting revenue, according to a presentation this week at HFMA’s Annual Conference. At University of New Mexico Hospital (UNMH), a recent chargemaster initiative began with a thorough review, said Holly Cruz, senior financial analyst with University…
Annual Conference: Healthcare entrepreneur Alex Oshmyansky describes his efforts to disrupt drug pricing
Arguably no segment of the healthcare industry is more susceptible to disruption than the market for prescription drugs, as Alex Oshmyansky, MD, PhD, made clear Wednesday morning during the closing session of HFMA’s Annual Conference. Oshmyansky spoke about his personal efforts to disrupt the pharmaceutical market in his role as co-founder and CEO of Mark…
Annual Conference: Keynote speaker Thomas Fisher tells a disturbing story about denial of care
Thomas Fisher, MD, MPH, author and emergency room physician for University of Chicago Medicine, might have made some members of the audience uncomfortable Tuesday at HFMA’s Annual Conference as he described a scenario that reflects poorly on at least one hospital. The situation boiled down to this: A man with a broken jaw and without…
Annual Conference: HFMA Chair Dennis Dahlen issues a call to action for healthcare finance professionals
The concept of punctuated equilibrium refers to systems that experience isolated episodes of dramatic evolution intermixed with long periods of stasis or something close to it. Dennis Dahlen, who on Tuesday morning was installed as HFMA’s National Chair for FY23-24, thinks the hypothesis applies to healthcare. Speaking to Annual Conference attendees, Dahlen, the CFO of…
Annual Conference: Joe Fifer says goodbye
In the 11 years that Joseph J. Fifer led HFMA, he successfully guided the Association through some difficult events. The COVID-19 pandemic, the social unrest related to racial issues and enduring political divisiveness were among the challenges experienced by HFMA under his watch. But Fifer never gave up on promoting the benefits of personal connections…