Utilization review staff may be hurting results when fixing incorrect inpatient admissions
There's a clear financial winner when choosing a method for correcting an incorrect inpatient admission.
The financial crunch of the pandemic is unlikely to subside anytime soon for hospitals
A leading credit-rating agency says the not-for-profit hospital sector will face significant headwinds for the rest of this year and beyond.
25% of Medicare patients suffer clinical harm in the hospital, OIG report indicates
A quarter of Medicare patients experienced harm while being treated in hospitals during a single month in 2018, according to a new report from the HHS Office of Inspector General.
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.
Hospital prices increasingly are coming under a microscope
Newly issued reports and policy recommendations are examining hospital prices in the context of high healthcare costs.
Hospitalists are more likely than other physicians to choose high-intensity codes for inpatient care, study finds
The billing and coding practices of hospitalists may contribute to the rising cost of hospital care in the U.S., according to conclusions of a new study.
Some Medicare payments to hospitals for bariatric surgery may be inappropriate, OIG finds
Medicare could have saved nearly $48 million in bariatric surgery payments to hospitals during an 18-month period if coverage rules and guidance were better implemented at the contractor level, according to the HHS Office of Inspector General.
2023 regulations for Medicare Advantage and ACA marketplaces seek to enhance network adequacy standards
HHS and CMS recently released sets of 2023 regulations that affect provider network adequacy standards in Medicare Advantage and the Affordable Care Act insurance marketplaces.
IPPS FY23 proposed rule: Tweaks are in store for Medicare’s quality-reporting and pay-for-performance programs
Temporary modifications to two pay-for-performance programs would ensure hospitals don’t face penalties amid the COVID-19 pandemic.
OIG calls out issues with denials of payment and services in Medicare Advantage
Medicare Advantage processes related to prior authorization hamper beneficiaries’ access to medically necessary care, according to a new report from the HHS Office of Inspector General.