Cost Effectiveness of Health

New rule on Medicaid DSH payments will impose stricter limits on many hospitals

Numerous hospitals that receive Medicaid disproportionate share hospital (DSH) payments face a tighter cap on their payment amounts after the Feb. 23 publication of a CMS final rule. The regulations were spawned by 2020 year-end legislation that made changes to the DSH hospital-specific limit (HSL), including with respect to how third-party payments factor into the…

Nick Hut February 23, 2024

Site-neutral payment has backing in healthcare policy circles, but its efficacy as a cost restraint is unclear

The concept of site-neutral payment continues to receive support from members of Congress and healthcare policy analysts, as demonstrated during a recent hearing. The Jan. 31 hearing of the House Energy and Commerce Committee’s Health Subcommittee was intended, in part, to promote pending legislation that would strengthen price transparency and implement other policies designed to…

Nick Hut February 15, 2024

Hospitals reached steadier ground financially as they moved into 2024

Hospitals came into 2024 with some financial momentum, even as expenses continued to rise and pivotal decisions loomed. The year-to-date median hospital operating margin reached 2.3% in December, the high mark for 2023 and the 10th consecutive month in which margins were positive, according to monthly data from Syntellis Performance Solutions, part of Strata Decision…

Nick Hut February 12, 2024

Cost Effectiveness of Health Report, January 2024

This issue of HFMA’s Cost Effectiveness of Health Report, sponsored by Kaufman, Hall & Associates, LLC, offers perspectives on developments in personalized medicine for patients and insights into how healthcare providers can help to maintain Medicaid coverage in their communities. Healthcare 2030 Let’s get personal: Tailoring care to the patient’s needs presents an opportunity for…

Eric C. Reese, PhD January 31, 2024

Asking the right questions to help patients age in place

Dan Weinrieb of Jukebox Health discusses why providers should be paying attention to fall risk in patients' homes.

Erika Grotto January 29, 2024

Employer-sponsored healthcare coverage would benefit from better access to data, Congress is told

Employers can stimulate efforts to improve the value of healthcare, but they need help in the form of better access to claims data and prices, according to testimony at a recent congressional hearing. With those tools in hand, employers can more easily forge provider partnerships that lower costs and raise healthcare quality, health benefit administrators…

Nick Hut January 26, 2024

Cost Effectiveness of Health Report, December 2023

This issue of HFMA’s Cost Effectiveness of Health Report, sponsored by Kaufman Hall, & Associates, LLC, provides insights from industry thought leaders on how hospitals and health systems can build trust among the people they serve. Other articles explore the benefits of improving interoperability and care coordination. Patient experience  10 Keys to restoring trust in healthcare By Nick Hut Key…

Eric C. Reese, PhD January 26, 2024

How a payer-provider collaboration around quality reporting can reduce costs and improve outcomes

Too often today, relations between provider and payer organizations can become contentious around issues related to payment and quality of care. Yet such conflict does not serve patients well, because it deflects these organizations’ attention from their underlying shared purpose: To work together to deliver well-coordinated, cost-effective healthcare to patients. With this purpose in mind,…

Brian Wheeler January 24, 2024

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…

Nick Hut January 16, 2024

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…

Nick Hut December 22, 2023
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