Monument Health revamps its revenue cycle leadership structure for the benefit of patients and the organization
Looking to break through the cultural silos that can hamper operations at hospitals and health systems, Monument Health has engineered a new brand of clinical-finance collaboration. Headquartered in Rapid City, South Dakota, the community-based health system established a dyad leadership structure in which a clinical leader has joint oversight of the revenue cycle. It’s a…
News Briefs: Healthcare industry disrupter CVS Health to shell out billions to buy Oak Street Health
A month after stating it hoped to gain a presence in primary care, CVS Health accomplished that goal with a massive deal that could fortify its efforts to advance value-based payment in healthcare. The proposed $10.6 billion acquisition of Oak Street Health, a provider of senior-focused primary care, adds to a portfolio of assets that…
(Updated 2) Texas court again backs providers in No Surprises Act independent dispute resolution litigation
A physician association continues to roil the No Surprises Act’s arbitration process through successful litigation. For the second time in a year, the Texas Medical Association (TMA) prevailed in court after arguing that regulations governing the independent dispute resolution (IDR) process do not comply with legislative intent. Barring a successful appeal, the Feb. 6 ruling…
How to meet your patients’ communication preferences and improve your bottom line
In this HFMA executive roundtable, seven health system leaders share their efforts to effectively engage patients and the lessons they have learned along the way.
News Briefs: 2023 brings a steep fee hike for No Surprises Act arbitration cases
The No Surprises Act’s independent dispute resolution (IDR) process has become more expensive for healthcare stakeholders. For the new year, the nonrefundable administrative fee due from each party involved in any payment dispute that goes to arbitration increased from $50 to $350, according to a Dec. 23 memo from CMS’s Center for Consumer Information and…
Key points to know in recently proposed rules for Medicare Advantage and the ACA marketplaces
A proposed rule for health plans in Medicare Advantage has provisions designed to stem overreach in prior authorization processes.
Labor costs and other concerns dampen the outlook for not-for-profit hospitals this year
Insights from a leading credit-rating agency illustrate the scope of the financial challenges facing not-for-profit hospitals in 2023.
For the No Surprises Act arbitration process, 2023 brings a steep fee hike and continuing litigation
The No Surprises Act’s independent dispute resolution (IDR) process is about to become more expensive for healthcare stakeholders. In 2023, the nonrefundable administrative fee due from each party involved in any payment dispute that goes to arbitration will increase from $50 to $350, according to a Dec. 23 memo from CMS’s Center for Consumer Information and Insurance…
Healthcare News of Note: More than 3,500 deaths in the US attributed to long COVID during a 30-month period
For a 30-month period beginning in January 2020, long COVID played a part in the deaths of 3,544 people, according to a report by the CDC’s National Center for Health Statistics. The Department of Justice has support from hospital advocates as it looks to appeal a court ruling that allowed UnitedHealth Group to acquire Change…
New federal rule aims to eventually ease prior authorization processes
CMS is seeking to improve the prior authorization process in government programs such as Medicare Advantage (MA) and Medicaid, although the core provisions would not begin until 2026. The agency this week updated a Trump administration proposed rule with new proposals to “improve patient and provider access to health information and streamline processes related to prior authorization…