Health Plan Payment and Reimbursement

The shift toward integrated pharmacy services: driving long-term success

One driving factor for health systems and hospitals shift to in-house integration pharmacy services is average turnaround time. For an outsourced specialty pharmacy, turnaround is 10 to 14 days, whereas an in-house specialty pharmacy can reduce that time to just 2.1 days.

HFMA August 31, 2022

HFMA’s virtual revenue cycle and price transparency series focuses on helping health systems re-engage consumers and improve financial performance

Beginning March 1, healthcare finance professionals can participate in several educational sessions and peer-to-peer discussions by enrolling in HFMA's virtual revenue cycle and price transparency workshop.

Deborah Filipek August 26, 2022

Final rule appears to give a boost to providers in No Surprises Act arbitration cases

A new final rule codifies updated criteria for deciding arbitration cases under the No Surprises Act, with providers potentially coming out ahead relative to last year’s interim final rule.

Nick Hut August 22, 2022

Healthcare News of Note: Americans have less confidence in the nation’s healthcare system

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Confidence in the U.S. healthcare system dips again, the median proposed health insurance premium increase for 2023 is about 10%, and improved oral care in hospitals can prevent pneumonia.

Deborah Filipek August 1, 2022

As revenue cycle challenges accumulate, a new survey suggests hospitals are taking a closer look at automation

For hospitals and health systems, survey results show that the ongoing labor crunch in revenue cycle operations has provided an impetus to expand process automation.

Nick Hut July 29, 2022

In an inflationary environment, pending Medicare payment updates don’t measure up

Consumer-focused inflation numbers aren’t as significant in healthcare as in other sectors, but prices are hampering hospitals and health systems.

Nick Hut July 25, 2022

Providers lose pair of Supreme Court decisions, including a case about disproportionate share hospital payments

In separate cases, the Supreme Court said HHS’s formula for determining DSH payments is statutorily correct and that health plans can limit outpatient dialysis coverage.

Nick Hut June 26, 2022

Texas-based study raises questions about impact of using additional criteria in No Surprises Act arbitration cases

Study results indicate that ongoing litigation over the independent dispute resolution process established by the No Surprises Act may not have a major impact on outcomes.

Nick Hut June 22, 2022

Insurer groups issue report showing the No Surprises Act’s early impact on patient billing

More than 2 million potential surprise medical bills were prevented during the first two months of the No Surprises Act, according to the health insurance lobby.

Nick Hut June 7, 2022

News Briefs: Hospital labor costs rose by almost 40% between 2019 and early 2022

As published in hfm magazine, a monthly roundup of top news for healthcare finance professionals.

Nick Hut May 27, 2022
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