Finance and Business Strategy

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

News Briefs: Financial and operational pressures continue for hospitals amid scattered positive signs

Recent financial data for the hospital industry illustrate continuing challenges even as some trends improve. Fitch Ratings released an analysis in early March that offers scant reason for optimism. Titled “Early NFP hospital medians show expected deterioration; will worsen,” it draws on data from hospitals with earlier 2022 financial year-ends. Those numbers show “materially weaker…

Nick Hut March 30, 2023

Robert Turner: Avoiding a bond covenant default takes aggressive action from a health system borrower

Not-for-profit hospitals and health systems have faced an increasingly difficult operating environment since inflation began to grow in mid-2021. Last year was particularly hard, beginning with a new wave of COVID-19 infections caused by the omicron variant, and followed by mounting expenses, staffing shortages, rising interest rates and investment losses. As a result, Kaufman Hall…

Robert Turner March 30, 2023

Reports on patient safety indicate progress, challenges and a need to focus on pediatric mental health

Recent reports add context to the issue of patient safety in hospitals and health systems. ECRI released a report that ranks the pediatric mental health crisis as the No. 1 patient safety issue in healthcare. The report cites a JAMA study that found increases of 29% in anxiety and 27% in depression between 2016 and…

Nick Hut March 29, 2023

Best practices for relieving unprecedented cost pressures facing healthcare providers

Due to labor cost increases, inflation, declining Medicare reimbursements and other reasons, health systems across the nation are feeling a new financial strain after the height of the pandemic.

HFMA March 29, 2023
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