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.
CMS Principal Deputy Administrator Jonathan Blum discusses price transparency, surprise billing and the future of value-based payment
HFMA President and CEO Joe Fifer interviews Jonathan Blum, principal deputy administrator and COO at CMS. In this interview, Blum discusses how CMS plans to phase out the public health emergency, how price transparency and surprise billing legislation are being received by provider organizations, and the effect the pandemic will have on CMS's value-based care strategy.
In the pandemic’s latest phase, strategic issues for healthcare providers include labor, inflation and value-based payment
The struggles of smaller providers amid the COVID-19 pandemic are likely to give way to increased merger-and-acquisition activity in 2022, according to Wall Street analysts.
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.
Big delays could be in store for early No Surprises Act arbitration cases
The portal for payment arbitration cases taking place under the No Surprises Act is open for business but could be facing a backlog of cases.
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.
Finding solutions to better manage payment process workflows
In this roundtable, revenue cycle leaders share their challenges, how they have enhanced payment processes through automation, and how they have identified opportunities for improvement.
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.