4 bipartisan healthcare policy changes are likely in 2025
HFMA policy experts see a high likelihood for far-reaching changes in healthcare policy following the November elections, with a focus on four areas: site-neutral payments, prior authorization, the 340B Drug Pricing Program, and mergers and acquisitions (M&A). The elections could produce a range of outcomes for the presidency and control of Congress. However, strong bipartisan…
Scrutiny in the Steward Health Care scandal
Nick Hut and Shawn Stack discuss the continuing bankruptcy proceedings of Steward Health Care and refusal of system CEO Ralph de la Torre to testify before the Senate.
News Briefs: Supreme Court ruling on Chevron makes regulations more vulnerable to legal challenges
The Supreme Court issued a decision June 28 that has dramatic implications for the regulatory infrastructure in healthcare, among many other industries. Under the Supreme Court’s 1984 Chevron v. Natural Resources Defense Council decision, courts were guided to give deference in their rulings to federal regulatory authorities such as CMS. Such agencies were deemed to…
Annual Conference Day 1: HFMA, AHA leaders hold forth on the state of the healthcare industry
HFMA’s 2024 Annual Conference began Monday afternoon with HFMA’s Ann Jordan and the American Hospital Association’s Rick Pollack rallying attendees to address the profound challenges and opportunities facing the industry. To start, Jordan, HFMA’s president and CEO, highlighted the conference theme, “A New Frontier in Health.” Frontier is “an exciting and unsettling word that really…
CMS’s 2024 MA rule brings some improvements but falls short of addressing all providers’ concerns
Hospitals and other healthcare providers welcomed CMS’s release in 2023 of the 2024 Medicare Advantage and Part D final rule (CMS-4201-F).a The rule represents CMS’s effort to refine the practices of MA organizations by placing limitations on prior authorization, elevating requirements for provider directories and making comprehensive adjustments to the MA and Part D quality…
A year after Silicon Valley Bank’s collapse, what have we learned about managing counterparty risk?
On March 8, 2023, Silicon Valley Bank (SVB) announced a $1.8 billion loss from the sale of securities to cover a decline in clients’ deposits. The following day, SVB’s stock dropped 60% and the bank saw a historic $42 billion in withdrawal requests. Twenty-four hours later, SVB was under the control of U.S. banking regulators…
Why U.S. policy needs to focus on pruning the healthcare transaction thicket
Despite its huge disruptive impact, the Change Healthcare cyberattack seems to be fading from the headlines even as the after-effects of this disruption linger. What remains, however, is the unsettling awareness not only that the U.S. healthcare payment “system” is not secure, but also that the hospitals and physicians’ offices we all rely on when…
Andrew Donahue: An open letter to Congress on nonprofit hospital finances
There’s a lot of bad information out there on nonprofit hospital finances. Part of the problem is run-of-the-mill scapegoating — stakeholders with an agenda using our business complexity to muddy the water. Part of the problem is classic misuse of information — good people with good intentions making the wrong assumptions. And part of the…
Hospitals say Supreme Court should hear a case that affects disproportionate share hospital payments
Hospital advocacy groups hope the Supreme Court will review a lower-court ruling that has adverse implications for Medicare disproportionate share hospital (DSH) payments. Six groups on Feb. 2 submitted an amicus brief to the Supreme Court regarding an appeals court’s 2023 decision backing HHS’s interpretation of the DSH payment formula. The department long has said…
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…