8 ways healthcare providers can smooth the DRG audit process
A health system’s financial sustainability depends on its being paid appropriately for the services it delivers. Yet routine payer audits can all too often result in downgrades of a health system’s billed diagnosis-related groups (DRGs), resulting in lower payment. It therefore behooves health systems to be well prepared for such audits and thoroughly understand why payers’ are most inclined to take such action.
Omicron, swelling expenses characterize end of another challenging year for hospitals, physician groups
The nation’s hospitals, health systems and physician groups closed the second year of the COVID-19 pandemic amid ballooning expenses exacerbated by nationwide labor shortages and global supply chain challenges.
Omicron, swelling expenses characterize end of another challenging year for hospitals, physician groups
The nation’s hospitals, health systems and physician groups closed the second year of the COVID-19 pandemic amid ballooning expenses exacerbated by nationwide labor shortages and global supply chain challenges.
Bold pursuits require persistence and curiosity
I hope this message finds you and your family safe, healthy and having had the opportunity to enjoy the holiday season. Safe and healthy is no small hurdle to surpass as of late. Over the past few months, we have encountered tornadoes, fires, storms and a new COVID variant that is making its way through…
Latest healthcare spending data paint a complicated picture of industry challenges and opportunities
Healthcare spending patterns during the first year of the COVID-19 pandemic reflect an industry trying to get its bearings amid a public health emergency and daunting long-term trends.
‘A just cause’: HFMA’s CEoH initiative addresses the factors that impede quality of health and raise healthcare costs
HFMA is moving forward with a global effort focused on the concept of cost effectiveness of health (CEoH), with the goal for promoting development of a system for care that is needed, accessible and affordable. A key message of this effort is that a broader focus on improving cost effectiveness of health — not just of healthcare — should be a strategic priority for healthcare leaders.
David Johnson: Cracks in the foundation — 5 structural defects are undermining nonprofit healthcare
The relentless organizational imperative under which nonprofit healthcare providers operate to optimize revenues under fee-for-service medicine has led to fragmented care delivery, unsustainable cost growth and severed connections with American consumers. Nonprofits should address five structural defects to their modus operandi that stand in the way of their delivering care empathetically and cost effectively to their patients.
Healthcare News of Note: Many health system boards find they are poorly equipped to institute DEI changes, says survey
Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Health system boards are willing to change but slow at implementing DEI measures, international nurses are filling the workforce gap, and youth mental health has suffered during the pandemic.
Cost Effectiveness of Health Report, February 2022
The January 2022 edition of HFMA’s Cost Effectiveness of Health Report, sponsored by Kaufman Hall, explores key tactics successful independent community hospitals use to help them sustain their mission to the communities they serve. Also included is a preview of the first of a series of columns by hfm columnist David Johnson addressing the need for nonprofit health systems to address 5 structural defects that keep them from delivering truly high-quality care to patients.
Cost Effectiveness of Health Report, December 2021
The December HFMA’s Cost Effectiveness of Health Report, sponsored by Kaufman Hall, leads off with the fourth and final report for 2021 in HFMA’s Healthcare 2030 series, focused on the long-term direction of strategic investment for hospitals and health systems. Also included are an article describing a new “employer-friendly” model of center of excellence and a commentary on how the FDA’s accelerated approval process may unintentionally be increasing the nation’s drug expense.