Annual Conference Day 3: UnitedHealth, Optum executives discuss resilience strategies for healthcare
Especially after being on the front lines of the most impactful cyberattack to hit the healthcare industry, leaders with UnitedHealth Group (UHG) and Optum have plenty of thoughts on how stakeholders can shore up their defenses. UHG is the parent company and Optum a sister company of Change Healthcare, which was the target of a…
Annual Conference Day 2: Keynote speaker Suneel Gupta expounds on the importance of recharging
Rest and breaks from work should be viewed not as a reward, but as a resource that supports performance, Suneel Gupta, wellness CEO, best-selling author and visiting scholar with Harvard Medical School, told HFMA Annual Conference attendees during Tuesday’s keynote presentation in Las Vegas. “When we look at the science behind human performance, what we…
Annual Conference Day 1: HFMA, AHA leaders hold forth on the state of the healthcare industry
HFMA’s 2024 Annual Conference began Monday afternoon with HFMA’s Ann Jordan and the American Hospital Association’s Rick Pollack rallying attendees to address the profound challenges and opportunities facing the industry. To start, Jordan, HFMA’s president and CEO, highlighted the conference theme, “A New Frontier in Health.” Frontier is “an exciting and unsettling word that really…
Preventive-services coverage mandate for Affordable Care Act plans remains intact following appeals court ruling
In a decision that could have been consequential for health insurance coverage offered through the Affordable Care Act (ACA) marketplaces, an appeals court limited the immediate impact. The U.S. Court of Appeals for the Fifth Circuit upheld a lower-court ruling that preventive-care mandates for ACA health plans are unconstitutional. But the appeals court said the…
Proposed rule to halt credit-reporting of medical debt would have big ramifications for hospitals and other providers
A proposed rule from the Consumer Financial Protection Bureau (CFPB) would curtail the inclusion of medical debt in credit evaluations, potentially shaking up healthcare billing and collections processes. The CFPB framed part of its rationale for the rule in the context of privacy, noting Congress previously limited the sharing of a patient’s medical information in…
Congress seeks to keep the momentum going on improvements to prior authorization
Members of Congress are revitalizing efforts to pass legislation that would streamline prior authorization in Medicare Advantage (MA). A bipartisan, bicameral group of legislators reintroduced the Improving Seniors’ Timely Access to Care Act, a bill that unanimously passed the House in September 2022 but did not receive a vote in the Senate. One obstacle at…
Hospitals can bring their case on disproportionate share hospital payments to the Supreme Court
The Supreme Court granted hospitals’ request that it hear their appeal about the formula for determining Medicare disproportionate share hospital (DSH) payments, landing the case on the docket for the 2024-25 term. More than 200 hospitals are plaintiffs in the case. A federal district court ruled for HHS and against the hospitals in 2022, and…
Health system CEO tells Congress proposed 340B changes would be harmful to organizations like his
A health system executive visited Capitol Hill recently to provide the hospital perspective on the 340B Drug Pricing Program — a viewpoint that increasingly is coming under fire among policymakers. Matthew Perry, president and CEO of Genesis HealthCare System in Zanesville, Ohio, appeared at a House subcommittee hearing June 4 to give insight on why…
The vital relationship between MDs and clinical documentation integrity
High-quality clinical documentation is vital for creating a complete picture of a patient’s health and medical history. Accurate records of diagnoses, medications, tests, treatments and other elements of a patient’s care are crucial in creating the most effective care plan leading to positive outcomes. The quality of a physician’s clinical documentation can also impact payer…
For providers, application of the 2-midnight rule to Medicare Advantage appears to bring a revenue influx
Hospitals appear to have gained a significant, albeit likely short-term, revenue boost from CMS’s 2023 directive to Medicare Advantage (MA) health plans regarding the two-midnight rule. The rule first was instituted in 2013 for Medicare fee-for-service (FFS), requiring the program to cover hospital stays as inpatient admissions if the admitting physician expects the stay to…