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…
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…
Here comes the Medicaid unwinding: The healthcare industry braces for coverage disruptions
A potentially tumultuous period for revenue cycle teams in particular and the U.S. healthcare system in general begins April 1, with the phasing out of a three-year run of Medicaid continuous enrollment. The so-called Medicaid “unwinding” originally was connected to end of the COVID-19 public health emergency (PHE), which is scheduled for May 11. But…
Healthcare Blame Game: How Kaiser Health News mistook policy for practice in hospital collections report
Brad Dennison is a 25-year veteran of the newspaper industry. He served 15 years as the top news executive for multiple national organizations and led thousands of journalists across the U.S., including investigative teams. He’s also a past board member of the Associated Press Media Editors, where he was elected national chair. Dennison joined HFMA…
Data capture and coding for social determinants of health are works in progress, per reports
In the effort to bring social determinants of health (SDoH) more under the purview of healthcare providers, one tricky aspect is establishing a data and coding infrastructure. Recent reports highlight this challenge. For example, a survey conducted for the American Health Information Management Association (AHIMA) found that although 78% of 2,637 respondents said their organizations…
Financial and operational pressures continue for hospitals amid some positive signs
New 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…
Navigating payer practices to reduce denials and enhance outcomes
The friction between payers and providers has existed for decades. It’s understandable to an extent. Payers want to reduce expensive and unnecessary treatment, eliminate fraud and lower financial risk. Providers want to be able to make decisions regarding their patients’ care without having to navigate the hurdles of medical necessity, prior authorization and complex payer…
Affordability of healthcare is not enhanced when providers form health systems, studies find
The efficiencies gained when providers operate as a health system don’t always translate to care that is more cost-effective, according to two recently published JAMA studies on pricing. In one study, researchers with Harvard Medical School and the National Bureau of Economic Research (NBER) examined 2018 data from various sources, including CMS administrative data, IRS…
Collecting with compassion: Patient financial care grows in importance
Health system leaders increasingly believe more communication is better when it comes to telling patients what they owe. When the pandemic began, Henry County Health Center’s revenue cycle department took a gamble to relieve the financial stress of care for patients. Executives for the 25-bed, Mount Pleasant, Iowa, critical access hospital, which serves a large…