The latest on hospital finances: Signs of improvement, but margins remain tight
Industry-level hospital financial insights reflect the mixed results of a recovery that’s in progress but is expected to be a long slog. In a 2023 midyear report (login required), Moody’s Investors Service noted that margins are below 3% for a third of the company’s rated hospitals. Before the pandemic, only about 6% had margins in…
A projected Medicare physician payment decrease spurs more calls to reform the system
Physician advocacy groups vehemently expressed concern about the financial consequences of CMS’s proposed rule for Medicare physician payments in 2024, intensifying a push to modify the payment system. At a time of elevated expenses in healthcare, total payments would be reduced by a projected 1.25% relative to 2023. That would follow a 2% decrease from…
House committee approves bill requiring national provider identifiers for off-campus outpatient departments
A bill with widespread support in Congress would affect hospital billing procedures at off-campus outpatient departments if it becomes law. The House Committee on Education and the Workforce on July 12 unanimously approved legislation called the Transparency in Billing Act, which states that starting in 2024, hospital claims for items and services furnished in off-campus…
Some of the best from HFMA’s Annual Conference in Nashville
Revisiting your investment strategy with Lisa Schneider of Russell Investments and PayMedix CEO Tom Policelli discusses why payment is so confusing for patients.
Medicare outpatient payments to hospitals won’t rise considerably in 2024, according to a proposed rule
Medicare’s newly proposed outpatient payment update for 2024 is unlikely to be greeted with enthusiasm by hospitals. The update for items and services provided in the hospital outpatient or ambulatory surgical center setting would be 2.8%, mirroring the proposed change for inpatient payments. The base update would be 3%, with a statutorily required productivity adjustment…
Annual Conference: Healthcare entrepreneur Alex Oshmyansky describes his efforts to disrupt drug pricing
Arguably no segment of the healthcare industry is more susceptible to disruption than the market for prescription drugs, as Alex Oshmyansky, MD, PhD, made clear Wednesday morning during the closing session of HFMA’s Annual Conference. Oshmyansky spoke about his personal efforts to disrupt the pharmaceutical market in his role as co-founder and CEO of Mark…
MedPAC takes aim at the Medicare wage index and reiterates support for site-neutral payment
In its semiannual report to Congress, the Medicare Payment Advisory Commission (MedPAC) recommends significant changes to two key aspects of Medicare policy: the wage index and site-neutral payment. 1. A revamp of the wage index The wage index consistently generates concern among healthcare stakeholders, including in Medicare’s FY24 proposed rule for hospital inpatient payments. According…
Congress seems inclined to expand site-neutral payment policies in Medicare (updated)
Momentum is building in Congress toward expanding site-neutral payment in Medicare, a move that could reduce payments to hospitals by billions of dollars per year. A recent hearing, which lasted 5 ½ hours, focused on various ideas for promoting transparency and competition in healthcare. The hearing included references to 17 bills or discussion drafts, several…
New data on No Surprises Act arbitration cases show providers are faring well amid systemic challenges
Providers are having success at challenging out-of-network payment amounts under the No Surprises Act, at least when they can get their cases through the arbitration system. CMS published an update showing that between April 15, 2022, when the independent dispute resolution (IDR) portal opened, and March 31, arbitrators issued payment determinations in 42,158 disputes. Initiating…
Honor Roll: HFMA certifications were awarded to 2,079 members January through March 2023
HFMA offers eight certifications for members to validate their expertise and demonstrate their commitment to the profession. The HFMA certifications are as follows: Certified Healthcare Financial Professional (CHFP), Certified Revenue Cycle Representative (CRCR), Certified Revenue Cycle Representative (CRCR) – GCC, Certified Specialist Accounting & Finance (CSAF), Certified Specialist Business Intelligence (CSBI), Certified Specialist Physician Practice…