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.
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.
FY 2023 Inpatient Prospective Payment System/LTCH Proposed Rule Summary
HFMA presents a detailed summary of the proposed rule updating policies and payment rates to inpatient prospective payment system hospitals and long-term care hospitals.