Finance and Business Strategy

Susan Dentzer: Why we have reached a tipping point on pharmaceutical spending 

Author Malcolm Gladwell famously wrote in a 2000 book about the phenomenon of tipping points — those moments when “critical mass, the threshold, [or] the boiling point” is reached and change occurs “not gradually but at one dramatic moment.”a One historical case in point: the collapse of the former Soviet Union, which, though building for years,…

Susan Dentzer, MS January 31, 2024

10 keys to restoring trust in healthcare: a summary

Note: This article was adapted from a report on HFMA’s 2023 Fall Thought Leadership Retreat. The full report is available for downloading. The issue of restoring consumer trust in the U.S. healthcare system encompasses a wide range of concerns. Factors in the perceived loss of trust include anxiety and confusion over costs, entrenched inequity, misinformation…

Nick Hut January 30, 2024

How healthcare finance organizations are working to become more resilient

Seven healthcare financial executives share their strategies for tackling the challenges of financial management in the current environment in this roundtable.

HFMA January 30, 2024

Most healthcare organizations will embrace two-sided value-based care models in 2024, but many do not have clearly defined protocols to assess new opportunities

Read this article for various lessons and questions to consider before entering a value-based care contract.

HFMA January 30, 2024

Healthcare in 2024: hfm columnists recount key issues finance leaders should keep on their radar

As 2024 begins to unfold, a key question challenges healthcare finance leaders: What are likely to be the defining issues for healthcare in the coming year?   Finance leaders should consider this question to make sure they are attuned to the potential for industry shifts, both positive and negative. And as they contemplate what’s in store…

Eric C. Reese, PhD January 30, 2024

News Briefs: A new fee is set for using the No Surprises Act arbitration portal

Bringing out-of-network payment disputes to arbitration under the No Surprises Act in 2024 will be less expensive than previously proposed. In a final rule, the U.S. Departments of Health and Human Services, Labor and Treasury established the administrative fee for using the independent dispute resolution (IDR) portal at $115 per case, effective Jan. 22. That’s…

Nick Hut January 30, 2024

Biden administration announces effort to make healthcare more competitive and transparent

Providers and insurers should be on the lookout for the Biden administration to hand down regulations and guidance intended to promote competition in healthcare. The White House in December released a fact sheet stating its position that a lack of competition affects healthcare prices and accessibility for consumers. Drug costs have been a target of…

Nick Hut January 30, 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

5 reasons to apply for a prestigious MAP Award for revenue cycle performance

For more than a decade, HFMA’s MAP Award for High Performance in Revenue Cycle has become the highest honor in the healthcare industry for revenue cycle excellence. If that’s not enough of a reason to apply for the chance at these accolades, here are five reasons why past winners apply year after year. 1. Bragging…

Greg Akroyd January 24, 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
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