Finance and Business Strategy

Hospitals are facing a long slog to return to pre-pandemic normalcy, panelists say

The logjam of patients who cannot be seen expeditiously at hospitals is becoming an entrenched problem with no imminent solutions, a CMS leader said this week. “The data tells us healthcare services, particularly for the Medicare population, have not come back to pre-pandemic levels,” said Jonathan Blum, principal deputy administrator and COO with CMS. “We’re…

Nick Hut April 21, 2023

Healthcare News of Note: What can be done to correct data disparities in women’s health?

The prevalence of women’s health conditions is roughly five times that of their documented diagnoses, which means for every woman diagnosed with a women’s health condition, roughly four go undiagnosed. The 2023 emergency medicine Match will see 555 initially unmatched positions, affecting a larger number of residency programs than in 2022, when 219 unmatched positions…

Deborah Filipek April 17, 2023

State of Medicare: Some good news on program solvency still leaves questions and challenges

Medicare should remain solvent a little bit longer than previously anticipated, while a policy debate is ramping up over how to make the program sustainable for the long term. The 2023 annual report of the Medicare Boards of Trustees projects that the Hospital Insurance (HI) trust fund, which subsidizes Part A services, essentially will be…

Nick Hut April 17, 2023

Medicare’s proposed FY24 update to inpatient payments falls short, hospitals say

Hospitals are less than pleased with Medicare’s proposed FY24 payment update for inpatient care. In proposed regulations, the net inpatient payment update is 2.8% after factoring in a mandatory productivity adjustment of -0.2 percentage points. As usual, the update would be reduced for any hospital that does not fulfill quality-reporting requirements or qualify as a…

Nick Hut April 12, 2023

Healthcare Blame Game, the podcast: First episode is here!

The much-anticipated pilot episode of the “Healthcare Blame Game” podcast is now live and available to HFMA members. In this episode, HFMA Chief Content Executive Brad Dennison and Executive Producer Erika Grotto question the methodology and narrative of a recent Kaiser Health News investigation.

Erika Grotto April 11, 2023

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…

Lisa A. Eramo, MA April 10, 2023

Healthcare News of Note:  The healthcare sector was targeted by nearly 24% of cyber-attack activity in 2022 

When it comes to the number of malicious cybersecurity events targeting customers in the Americas, the healthcare industry is second, just behind finance.  Contrary to its previously announced plans, the U.S. Department of Justice is not pursuing a further challenge to UnitedHealth Group’s purchase of Change Healthcare.  The average pay for physicians decreased 2.4% in…

Deborah Filipek April 10, 2023

CMS and other stakeholders take steps to improve prior authorization in Medicare Advantage and beyond

Several recent developments point to an industrywide effort to ease the burden of prior authorization. Most notably, CMS on April 5 finalized a rule that includes provisions designed to improve prior authorization in Medicare Advantage (MA) starting with the 2024 plan year. The rule addresses a few aspects of prior authorization, among them the way…

Nick Hut April 6, 2023

Court decision means cost sharing could be reinstated for some preventive healthcare services

Comprehensive coverage of some preventive care services could be jeopardized by a recent court ruling. Since its passage, the Affordable Care Act (ACA) had required health plans to cover the full cost of services that received an “A” or “B” rating from the U.S. Preventive Services Task Force (USPSTF). A federal judge in Texas ended…

Nick Hut April 2, 2023

Maryland’s all-inclusive population health payment model continues to show promise, but nonhospital spending poses a concern

An innovative payment model for Maryland healthcare providers has improved utilization, cost and quality thus far, but an increase in nonhospital spending requires further study. The Center for Medicare & Medicaid Innovation (CMMI) released an analysis of the first three years of Maryland’s Total Cost of Care Model, an effort to improve population health management.…

Nick Hut March 31, 2023
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