No Surprises Act arbitration has been a bonanza for a few provider groups
In a span of 2.5 years through 2024, providers reaped more than $2.2 billion from the No Surprises Act’s arbitration process, relative to the applicable in-network payment rates for the disputed care episodes. The awards received through the NSA’s independent dispute resolution (IDR) process largely arise from “disputes that are primarily initiated and won by…
Hospitals still face a heavy lift getting ready for the TEAM bundled payments model
For the quarter of U.S. hospitals that will participate in the mandatory Transforming Episode Accountability Model (TEAM) starting Jan. 1, 2026, the preparation curve has been steep. In early August, among more than 90 client hospitals of the solutions company Rainfall Health, none was where participants soon need to be, said Eddie Qureshi, founder and…
News Briefs: Medicare offers a restrained inpatient payment update for FY26
Hospitals collectively will receive a base payment increase of 2.6% in Medicare reimbursement for inpatient care provided in FY26, according to a final rule published Aug. 6 in the Federal Register. Advocates were seeking a bigger update. With rising costs and reimbursement constraints projected in upcoming years, especially after passage of the budget reconciliation bill known as the…
Government shutdown watch: Various hospital funding sources to be curtailed (updated 11/17/25)
Nov. 17 update: Sizable Medicare payment cut avoided The continuing resolution to fund the government through Jan. 30 has language canceling a looming PAYGO reduction to federal programs, including a 4% cut to Medicare that would have taken effect in 2026. PAYGO is a statutory across-the-board spending reduction to be implemented when legislation increases the…
People: Alyson Belz recognized as a member of 40 Under 40 Class of 2025
Selected from hundreds of fellow nominees, Alyson Belz, FHFMA, MBA, has been named to Crain’s New York Business 40 under 40, which highlights dynamic young professionals across industries who demonstrate meaningful leadership in their communities. The honor caps Belz’s more than a decade of leadership experience focused on improving outcomes and reducing inefficiencies. She currently…
CareCloud Announces Acquisition of HFMA’s MAP App to Expand AI-Driven Benchmarking in Hospitals and Integrated Health Systems
CareCloud, Inc. announced its definitive agreement to acquire MAP App to deliver next level innovation and improvements. The transition period is through the end of 2025. There should be no significant changes to MAP App users, and clients should continue in the tool as they would normally.
HFMA and Third Horizon launch price transparency data tool Starset Analytics
Exclusive to HFMA Enterprise Solution Provider Members, the tool transforms complex pricing data into actionable insights for negotiation, benchmarking and strategy. CHICAGO (Sept. 29, 2025) – The Healthcare Financial Management Association (HFMA) and Third Horizon today announced the launch of Starset Analytics, a new toolset that helps hospitals unlock the full potential of price transparency…
Hospital financial metrics remain steady even as costs rise and reimbursement challenges await
The latest data on financials for the not-for-profit (NFP) hospital sector hints at the challenges in store. While margins have not taken a significant hit for health systems, other metrics reflect rising costs, according to the latest monthly report from Strata Decision Technology. Beyond that immediate concern is the prospect of reduced reimbursement not only…
Proposed 340B rebate model generates an array of concerns among providers
Hospital advocates are pushing back on a fast-approaching rebate model for the 340B Drug Pricing Program, while a new Congressional Budget Office (CBO) report illustrates the accelerating spending in the program. The Health Resources and Services Administration (HRSA), which administers 340B, previously announced that a pilot program to test the application of a rebate model…
The hospital tax exemption comes under scrutiny in Congress
At a time when concerns over reimbursement and costs already are intensifying, Congress recently held a hearing to discuss policy changes that could exert further pressure on the not-for-profit (NFP) hospital sector. A subcommittee of the House Ways and Means Committee met Sept. 16 to examine the NFP hospital tax exemption, soliciting proposals that could…