Closures of Walmart’s health centers reflect the widespread financial constraints in U.S. healthcare
Beyond signaling a setback for retail-based healthcare disruptors, Walmart’s recent decision to close its health centers is symptomatic of issues hampering the nation’s ecosystem for primary care, industry analysts say. The retail behemoth announced April 30 it would be closing all 51 of its health centers across five states, along with its virtual-health service. Five…
News Briefs: Hospital advocates bemoan the small Medicare payment increase proposed for FY25
The payment update described in Medicare’s FY25 proposed rule for inpatient hospital care and long-term care hospitals falls well short of what hospitals need to keep up with costs, advocates say. The inpatient payment rate would rise by 2.6% for hospitals that fulfill quality-reporting requirements and meet the criteria to be designated as meaningful users…
A year after Silicon Valley Bank’s collapse, what have we learned about managing counterparty risk?
On March 8, 2023, Silicon Valley Bank (SVB) announced a $1.8 billion loss from the sale of securities to cover a decline in clients’ deposits. The following day, SVB’s stock dropped 60% and the bank saw a historic $42 billion in withdrawal requests. Twenty-four hours later, SVB was under the control of U.S. banking regulators…
Insurers see reasons for concern as CMS keeps the Medicare Advantage purse strings tight for 2025
Medicare Advantage (MA) faces the prospect of constrained revenue and payments for participating stakeholders after CMS finalized what amounts to a small decrease in the 2025 payment rate. Average revenue for MA plans is projected to increase by 3.7%, or more than $16 billion — but that’s primarily because of a prospective increase in the…
News Briefs: Providers face trying times in the first month after the Change Healthcare cyberattack
Healthcare providers struggled financially and operationally in the first 30 days after a Feb. 21 cyberattack forced the shutdown of Change Healthcare’s claims submission and payment systems, among more than 100 other applications. As of the week of March 18, parent company UnitedHealth Group had restored Change Healthcare’s payment platform and was reporting progress in…
Hospital finances are on the upswing, but the toll of the Change Healthcare outage is yet to be seen
Note: The second section of this article was updated where noted with a new comment from Fitch Ratings. There is reason to be optimistic about the state of hospital finances, but the impact of the Change Healthcare cyberattack has added uncertainty to the forecasts. Financial metrics for the first two months of 2024 continued to…
Payer trends health systems should watch closely in 2024
Health system leaders focused on the day-to-day needs of their organization can sometimes lose sight of key developments in other sectors of healthcare. But in an interconnected healthcare ecosystem, understanding the trendlines their payer counterparts are facing is essential. Threats to payers While some health system leaders might be under the impression that payers are…
Hospitals warrant an extra boost in their Medicare payment rate next year, MedPAC says
Hospitals will get a more favorable Medicare payment increase in FY25 if Congress follows the recommendations of the Medicare Payment Advisory Commission (MedPAC). In its semiannual report to Congress, MedPAC recommended a 1.5% bump on top of what otherwise would be provided according to statute. That would mean an estimated increase of about 4.5% for…
Responses to a new RFI will help guide regulations addressing consolidation and private equity in healthcare
The Biden administration is ramping up its assessment of how to regulate consolidation and private equity (PE) acquisitions in healthcare, issuing a request for information (RFI) from stakeholders. There is a deadline of May 6 to submit comments on the RFI, which was distributed by HHS, the Department of Justice (DOJ) and the Federal Trade…
New data shows providers continuing to win most No Surprises Act independent dispute resolution cases
Providers won a large majority of disputes initiated during the first half of 2023 through the No Surprises Act’s arbitration portal for adjudicating out-of-network payments, according to newly published data. HHS and the U.S. Departments of Labor and Treasury released public-use files (available to download here under “2023 Reporting Year”) showing the outcome of every…