Payment Reimbursement and Managed Care

The state of the 340B program: What the Supreme Court’s Affordable Care Act ruling meant, and which issues still loom

An under-the-radar aspect of the Supreme Court’s ruling on the Affordable Care Act involved hospital eligibility for the 340B program, an industry expert says.

Nick Hut June 25, 2021

Transitioning health systems to accepting more risk: Key steps to ensuring financial sustainability

The COVID-19 pandemic has renewed many health systems’ interest in pursuing population health initiatives. Yet success with such initiatives will remain elusive if they do not address two common barriers to success: lack of aligned incentives and insufficient infrastructure.

Orry Jacobs, MBA June 24, 2021

In response to requests, HHS offers accommodations on deadlines for Provider Relief Fund spending and reporting (updated)

The new deadlines apply to allocations received after June 30, 2020. Reporting on use of funds is required only for designated time periods during which a provider’s payment exceeded $10,000.

Nick Hut June 23, 2021

HFMA survey of healthcare finance professionals highlights continuing pandemic-related challenges and some reasons for optimism

Results of HFMA's Outlook Survey show that the healthcare industry is still coping with the challenges of COVID-19 but has started to adapt to a post-pandemic future.

Nick Hut June 22, 2021

Healthcare News of Note: More healthcare organizations mandating that employees receive the COVID-19 vaccine

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: COVID-19 vaccine mandates become more popular among healthcare organizations, hospitals continue to skirt price transparency rules, and healthcare workers get help in coping with trauma.

Deborah Filipek June 22, 2021

Medicare indirect medical education payments to teaching hospitals should be overhauled, MedPAC says

Although the proposals represent a significant change, most hospitals wouldn’t be projected to experience a large impact on their payments.

Nick Hut June 21, 2021

Supreme Court leaves Affordable Care Act intact, but stakeholders say healthcare reform still has a ways to go

Hospital advocates applauded a Supreme Court ruling June 17 that left the Affordable Care Act in place.

Nick Hut June 18, 2021

MedPAC report: Cost-based reimbursement isn’t an ideal way to sustain rural hospitals

An extensive healthcare policy report by the Medicare Payment and Advisory Commission includes a discussion about the drawbacks of cost-based Medicare reimbursement for rural hospitals.

Nick Hut June 16, 2021

HHS sends letter to providers, insurers reinforcing requirements for COVID-19 vaccination and testing to be free for all recipients

Xavier Becerra, secretary of HHS, issued a letter emphasizing that out-of-pocket fees for COVID-19-related services are prohibited.

Nick Hut June 13, 2021

CMS proposes to pull support from organ acquisitions: A grave threat to the future of U.S. organ transplants and donor programs

Transplant patient lives at risk under CMS’s proposal to stop supporting donor community hospitals excising organs for non-Medicare patients on waiting lists.

Shawn Stack June 11, 2021
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