Reimbursement

Medicare outpatient payments to hospitals won’t rise considerably in 2024, according to a proposed rule

Medicare’s newly proposed outpatient payment update for 2024 is unlikely to be greeted with enthusiasm by hospitals. The update for items and services provided in the hospital outpatient or ambulatory surgical center setting would be 2.8%, mirroring the proposed change for inpatient payments. The base update would be 3%, with a statutorily required productivity adjustment…

Nick Hut July 14, 2023

10 Vital Responses to Healthcare Disruption

Disruption is reverberating throughout the healthcare industry, and it’s incumbent on legacy organizations to develop strategic responses for the benefit of their consumers, their communities and themselves. With that overarching challenge becoming ever more pressing, HFMA’s 2023 Spring Thought Leadership Retreat brought together leaders from across the industry May 4-5 in Atlanta to consider approaches…

Nick Hut July 11, 2023

Billions of dollars in lump-sum payments are coming to hospitals as a remedy for 340B-related underpayments

Hospitals that participate in the 340B Drug Pricing Program stand to receive $9 billion in aggregate lump-sum payments as compensation for underpayments from Medicare during a nearly five-year period. In a proposed rule issued July 7, CMS described how it would provide remedies following a 2022 Supreme Court ruling that the U.S. Department of Health…

Nick Hut July 10, 2023

Annual Conference: For hospitals, effective chargemaster management can bolster revenue capture

Amid the changes and challenges buffeting the hospital and health system sector, chargemaster management remains a key step in protecting revenue, according to a presentation this week at HFMA’s Annual Conference. At University of New Mexico Hospital (UNMH), a recent chargemaster initiative began with a thorough review, said Holly Cruz, senior financial analyst with University…

Nick Hut June 28, 2023

Annual Conference: Health system CFO panel reflects on the importance of embracing change

The healthcare industry is enduring tough times, but finance leaders are equipped to guide their organizations through choppy waters, CFOs said Sunday as part of a panel discussion. Speaking onstage during the opening session of HFMA’s Annual Conference in Nashville, five health system CFOs described how they’ve responded during a tumultuous period that began more…

Nick Hut June 25, 2023

Denials Management Research Report

HFMA, with sponsorship from Waystar, surveyed 415 healthcare finance and revenue cycle executives to understand how denials are affecting their revenue cycle operations.

HFMA June 22, 2023

Survey reveals 5 opportunities to tackle denial prevention and management

In this survey, responses found when organizations devote greater resources to denial management than to denial prevention, their rate of first-pass denials is higher: 13.6% versus 10.9%.

HFMA June 22, 2023

MedPAC takes aim at the Medicare wage index and reiterates support for site-neutral payment

In its semiannual report to Congress, the Medicare Payment Advisory Commission (MedPAC) recommends significant changes to two key aspects of Medicare policy: the wage index and site-neutral payment. 1. A revamp of the wage index The wage index consistently generates concern among healthcare stakeholders, including in Medicare’s FY24 proposed rule for hospital inpatient payments. According…

Nick Hut June 22, 2023

HFMA Annual Conference preview: How Vanderbilt University Medical Center built a successful bundled payment program

Dr. Brittany Cunningham from Vanderbilt University Medical Center discusses her upcoming presentation at HFMA's Annual Conference in Nashville. Also in this episode, strategies for cash flow discrepancies with sponsor organization Inovalon.

Erika Grotto June 21, 2023

Medicaid Drug Misclassification Proposed Rule Summary

The rule proposes to implement policies in the Medicaid Drug Rebate Program (MDRP) related to legislative requirements addressing drug misclassification, as well as drug pricing and product data misreporting by manufacturers.

HFMA June 20, 2023
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