CMS looks to fortify primary care with proposed new codes for advanced care management
With newly proposed regulations, CMS aims to establish coding and payment for services that promote longitudinal relationships between clinicians and patients in primary care. The provisions, part of Medicare’s 2025 proposed rule for physician payments, incorporate new HCPCS G-codes for advanced primary care management (APCM). Three bundles of APCM services would be billable as codes…
A proposed Medicare condition of participation would bring a slew of new requirements for OB care
Note: HFMA’s coverage of the payment update in the outpatient payment proposed rule can be found here. Hospitals intending to participate in Medicare must meet new standards for obstetric (OB) care, according to CMS’s proposed outpatient rule for 2025. The rule proposes to establish a new Medicare condition of participation (CoP), whereby hospitals and critical…
The state of U.S. primary care: How new ways of thinking can spur meaningful improvement
As healthcare stakeholders consider ways to fortify the nation’s primary care system, industry leaders recommend emphasizing several strategies and components — and not waiting to act. “We’re close to midnight in many respects in thinking about how to urgently preserve and expand primary care in America,” Susan Dentzer, president and CEO of America’s Physician Groups…
Recent updates and emerging best practices for ACOs in the Medicare Shared Savings Program
Going into the 12th year since it brought accountable care into the healthcare lexicon, the Medicare Shared Savings Program (MSSP) continues to evolve, with CMS making changes and participants fine-tuning best practices. Starting with 220 accountable care organizations (ACOs) in 2012-13, the MSSP grew to 561 in 2018. However, the number has been below 500…
2024 outlook: Hospitals can expect a steadier year financially, but key questions loom
Although the past year brought more stability for the not-for-profit hospital sector, analysts foresee 2024 as a pivotal period in determining the viability of individual organizations. Fitch Ratings continues to describe the sector’s outlook as “Deteriorating.” In a year-end report, the credit-rating agency said downgrades of hospitals and health systems in 2023 had outpaced upgrades…
HFMA strategy session highlights challenges and opportunities for healthcare finance leaders: payer relations, supply costs, AI and more
The legacy healthcare provider’s position in the industry could grow tenuous if leaders don’t respond boldly and strategically to ongoing trends, according to insights recently presented to HFMA leaders. “We’re at a crossroads right now,” Ashraf Shehata, principal and U.S. national sector leader for healthcare and life sciences with KPMG, said in November during a…
Insights on population health management challenges through the eyes of C-suite leaders
Population health management is at a crossroads, and one key to ensuring its viability is to bolster stakeholder trust in the potential of value-based payment (VBP) models. That was a key takeaway from healthcare executives who took part in a September panel discussion at the 23rd annual Population Health Colloquium, hosted by the Jefferson College…
10 Vital Responses to Healthcare Disruption
Disruption is reverberating throughout the healthcare industry, and it’s incumbent on legacy organizations to develop strategic responses for the benefit of their consumers, their communities and themselves. With that overarching challenge becoming ever more pressing, HFMA’s 2023 Spring Thought Leadership Retreat brought together leaders from across the industry May 4-5 in Atlanta to consider approaches…
Healthcare News of Note: Healthcare private equity deals amounted to a strong $90B in 2022
In 2022, healthcare private equity deals reached nearly $90 billion, the second highest on record. Concerns about increased workloads, staffing shortages and burnout have been felt most acutely by less experienced nurses, according to a newly published study. Patients seeking care in safety-net clinics are accruing chronic diseases at high rates in middle age, indicating…
Hospital operational changes underway as health equity becomes one of The Joint Commission’s National Patient Safety Goals
Reducing healthcare disparities became a Joint Commission accreditation standard (LD.04.03.08) on Jan. 1, a little more than a year after the organization issued a Sentinel Event Alert warning of impacts on patient safety. However, on July 1, the standard will become a National Patient Safety Goal (NPSG), which experts say points to one thing: Healthcare…