Payment Reimbursement and Managed Care

Supreme Court unanimously finds that CMS veered out of bounds when it lowered drug payments for 340B hospitals

In a 9-0 ruling, the Supreme Court said CMS didn’t have the authority to lower drug reimbursement amounts for 340B hospitals as it did in 2018 and 2019.

Nick Hut June 16, 2022

State of Medicare: Trustees push back projected date of Part A insolvency, but issues must be addressed

Even though the Hospital Insurance Trust Fund now is expected to be depleted in 2028 instead of 2026, Medicare still faces daunting challenges.

Nick Hut June 15, 2022

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.

Ronald Hirsch, MD June 9, 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

Cost Effectiveness of Health Report, May 2022

The May 2022 edition of HFMA’s Cost Effectiveness of Health Report includes a conversation with Lance Robertson, former U.S. Assistant Secretary for Aging at the U.S. Department of Health and Human Services Administration for Community Living, on practical ways the United States can begin to meaningfully address social determinants of health. Another article explores considerations for hospitals and health systems regarding the decision to pursue a “hospital at home” strategy, and a column shares perspectives and lessons learned from a 47-year active member of HFMA on the nation’s evolution toward value.

HFMA June 1, 2022

How HFMA/Boise State master’s degree cohort members are putting new knowledge to work

Abby Birch, Grayson Johnston and Jacob Dalmas, three members of the first HFMA/Boise State master's in Population and Health Systems Management cohort, discuss their experiences in the program.

Deborah Filipek June 1, 2022

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.

Nick Hut May 31, 2022

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.

Nick Hut May 30, 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

David Johnson: Cracks in the foundation – Overcoming regulatory headwinds

Healthcare leaders have an important opportunity today use the new regulations to drive value-based care throughout their organizations. But that doesn’t mean completely relinquishing their traditional revenue streams. To seize this opportunity, they should undertake a dual transformation that promotes more efficient operation of their traditional businesses, while nurturing and growing new businesses focused on population health and value.

David W. Johnson May 27, 2022
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