Reimbursement

Healthcare News of Note: Many health system boards find they are poorly equipped to institute DEI changes, says survey

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Health system boards are willing to change but slow at implementing DEI measures, international nurses are filling the workforce gap, and youth mental health has suffered during the pandemic.

Deborah Filipek January 28, 2022

Healthcare News of Note: McKinsey analyzes a range of scenarios based on the infectiousness, immune evasion and severity of disease linked to the omicron variant

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: An in-depth analysis looked at what the U.S. can expect with the onslaught of the omicron variant, CMS rescinded a drug pricing model, and total healthcare utilization in 2020 dipped below 2019 levels.

Deborah Filipek January 28, 2022

Survey: Health systems push toward risk-based payment models, payer-provider partnerships

Check out the key takeaways from a survey conducted in Summer 2021 with healthcare executives, which focused on risk-based models, data issues, leaders’ concerns on hitting budgets and more.

Crystal Milazzo January 28, 2022

HHS’s Office of Inspector General announces audit of providers’ COVID-19 billing practices

OIG has announced an audit of Provider Relief Fund recipients to ensure they did not balance-bill presumptive or actual COVID-19 patients.

Nick Hut January 26, 2022

Hospitals need federal support to handle the ongoing staffing and financial crunch, industry leaders say

The hospital industry issued its latest plea for additional federal help to mitigate the financial and operational strain of COVID-19, including surging staffing costs.

Nick Hut January 26, 2022

Healthcare stakeholders are invited to contribute suggestions for improving prior authorization

A two-month comment period is available for healthcare stakeholders to suggest electronic standards that would make the prior authorization process more efficient.

Nick Hut January 24, 2022

The COVID-19 vaccine mandate for healthcare workers can take effect nationwide, Supreme Court says

The court lifted injunctions that had halted implementation of the COVID-19 vaccine mandate in half the country, leaving hospitals and other affected providers with likely only a few weeks to begin complying.

Nick Hut January 21, 2022

Research seeks to pinpoint health system characteristics associated with the tendency to ‘overuse’ healthcare

Higher bed counts, fewer primary care physicians and investor ownership are among the characteristics of health systems that tend to overuse healthcare, according to a new study.

Nick Hut January 20, 2022

Coverage denials based on medical necessity are far more likely to arise from Medicare FFS rules than from MA plan policies

Coverage rules stemming from Medicare national and local determinations were the most likely cause of claim denials in one Medicare Advantage plan.

Nick Hut January 18, 2022

CMS proposes to restrict Medicare coverage of a high-profile new Alzheimer’s drug

Medicare will pay for use of a new drug to treat Alzheimer’s disease only for patients in approved clinical trials, CMS said in a proposed coverage determination.

Nick Hut January 12, 2022
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