Medicare Payment and Reimbursement

Legislation to enhance healthcare pricing and billing transparency takes a big step forward in the House

A slew of provisions on healthcare transparency took a step closer to becoming federal law as three House committees last week merged separate bills into a single draft. The resulting bill is just about set for consideration by the full House, where bipartisan support for the major provisions was apparent in the committee phase. The…

Nick Hut September 14, 2023

CY 2024 OPPS/ASC Proposed Rule Summary

HFMA presents a detailed summary of the proposed rule issued by CMS updating payments under the hospital outpatient prospective payment system and the ambulatory surgical center payment system for CY 2024.

HFMA September 8, 2023

The evolution of telehealth and the potential for sustainability

The surge in use of telehealth services seen during the pandemic has slowed, but telehealth remains a key modality amid policy changes that will help set the course for the future of virtual care. “There’s no alternative,” said Kyle Zebley, senior vice president for public policy with the American Telemedicine Association (ATA) and executive director…

Elizabeth Barker August 30, 2023

FY 2024 IPPS/LTCH Final Rule Summary

HFMA presents a detailed summary of the final rule released by CMS describing federal FY 2024 policies and rates for Medicare’s inpatient prospective payment system and the long-term care hospital prospective payment system.

HFMA August 30, 2023

News Briefs: Hospitals foresee adverse impacts from the FY24 inpatient payment rule

The FY24 final rule for Medicare inpatient payments didn’t bring hospitals the type of rate update they had sought, and for some organizations, a bigger concern is changes to uncompensated care (UC) payments. The regulations, which take effect Oct. 1, establish a 3.1% increase in operating payment rates, on average, for hospitals that meet quality-reporting…

Nick Hut August 30, 2023

Prices of drugs for diabetes, heart failure and more will be up for negotiation in Medicare next year

The U.S. Department of Health and Human Services (HHS) on Tuesday announced the first 10 Medicare Part D drugs that will be subject to price negotiations, the headlining healthcare-related provision of the Inflation Reduction Act. Signed in August 2022, the law gave Medicare authority to negotiate with drug manufacturers over the prices of selected drugs.…

Nick Hut August 29, 2023

Healthcare News of Note: Latino, Black and Asian people ‘significantly more likely’ to enroll in Medicare Advantage

Among beneficiaries of color, Medicare Advantage enrollees are demographically and geographically different from those in fee-for-service Medicare. Turnover among hospital CEOs has trended downward since hitting 20% in 2013. Eleven of the 100 U.S. hospitals to earn NRC Health’s Consumer Loyalty Award were also honored with the organization’s Consumer Loyalty “Best in Class” Award for…

Deborah Filipek August 28, 2023

FY 2024 Skilled Nursing Facilities PPS Final Rule Summary

HFMA presents a detailed summary of the final rule updating the Medicare skilled nursing facility (SNF) payment rates for FY 2024.

HFMA August 23, 2023

FY 2024 Hospice Payment Rate Update Final Rule Summary

HFMA provides a detailed summary of the final rule updating the Medicare hospice payment rates, wage index, the cap amount and the quality reporting requirements for FY 2024.

HFMA August 15, 2023

Healthcare News of Note: 10 drugs account for a large share of Medicare Part D spending

In total, Part D gross spending rose from $166 billion in 2018 to $216 billion in 2021.  In 2023, customer personal identifiable information costs organizations $183 per record and employee PII costs $181 per record.  Average length across all clinical notes increased 8.1%, from 4,628 characters in May 2020 to 5,002 characters in April 2023. …

Deborah Filipek August 11, 2023
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