Hospitalists are more likely than other physicians to choose high-intensity codes for inpatient care, study finds
The billing and coding practices of hospitalists may contribute to the rising cost of hospital care in the U.S., according to conclusions of a new study.
Some Medicare payments to hospitals for bariatric surgery may be inappropriate, OIG finds
Medicare could have saved nearly $48 million in bariatric surgery payments to hospitals during an 18-month period if coverage rules and guidance were better implemented at the contractor level, according to the HHS Office of Inspector General.
In the pandemic’s latest phase, strategic issues for healthcare providers include labor, inflation and value-based payment
The struggles of smaller providers amid the COVID-19 pandemic are likely to give way to increased merger-and-acquisition activity in 2022, according to Wall Street analysts.
2023 regulations for Medicare Advantage and ACA marketplaces seek to enhance network adequacy standards
HHS and CMS recently released sets of 2023 regulations that affect provider network adequacy standards in Medicare Advantage and the Affordable Care Act insurance marketplaces.
Big delays could be in store for early No Surprises Act arbitration cases
The portal for payment arbitration cases taking place under the No Surprises Act is open for business but could be facing a backlog of cases.
IPPS FY23 proposed rule: Tweaks are in store for Medicare’s quality-reporting and pay-for-performance programs
Temporary modifications to two pay-for-performance programs would ensure hospitals don’t face penalties amid the COVID-19 pandemic.
Latest financial metrics for hospitals show reasons for optimism but also persistent challenges
Hospital financial performance partially recovered in March as patient volumes returned to something closer to normal after a significant downturn during the omicron wave.
OIG calls out issues with denials of payment and services in Medicare Advantage
Medicare Advantage processes related to prior authorization hamper beneficiaries’ access to medically necessary care, according to a new report from the HHS Office of Inspector General.
M&A update: A quiet quarter for hospital deal-making reflects the ongoing consequences of the pandemic
Merger-and-acquisition activity among hospitals and health systems remained well under pre-pandemic levels in Q1 2022.
Tentative deal to provide pandemic funding won’t replenish the COVID-19 Uninsured Program
A bipartisan Senate bill would pay for additional vaccines and therapeutics but wouldn’t restore funding to a program that reimburses providers for furnishing COVID-19-related services to the uninsured.