After OIG says hospitals may be engaging in upcoding, CMS and AHA dispute the finding
The HHS Office of Inspector General says a significant rise in high-severity inpatient admissions with no corresponding increase in length of stay indicates a possible pattern of upcoding by hospitals in recent years.
New federal guidance seeks to clarify reimbursement of COVID-19 testing and vaccinations
Federal agencies have issued new guidance intended to make it easier for healthcare providers to receive reimbursement for administering COVID-19 tests to insured individuals and for giving vaccinations to the uninsured.
SVP Rick Gundling recaps new workshops, Biden and surprise bills
Rick Gundling, HFMA’s senior vice president of professional practice, talks about the Association's education plans for 2021 and comments on some hot topics in healthcare.
Denials management: An underrated tool for optimizing value-based revenue
Effective denials management not only supports a strong revenue stream under existing fee-for-service payment models, but also is a key tool for managing the full range of value-based payment contracts.
Healthcare News of Note: Xavier Becerra likely to be confirmed as next U.S. Department of Health and Human Services secretary
Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles, including information on the likely confirmation of Xavier Becerra as HHS secretary, which specialists are seeing an uptick in patients and lingering health issues from COVID-19.
Prospective HHS secretary: ‘We will do robust enforcement to make sure that price transparency is there for all Americans’
Xavier Becerra, the nominee to be secretary of Health and Human Services in the Biden administration, said transparency is a vital step in addressing the issue of healthcare prices.
News Briefs: Latest patient volume data reveals some of the challenges facing hospitals in the COVID-19 era
Recent industry reports have quantified the impact of the COVID-19 pandemic on hospital patient volume.
RAND report finds regulating hospital prices would be the most effective way to reduce healthcare spending, but are the proposals viable?
The American Hospital Association had a negative reaction to study findings showing that regulation of hospital prices would be the most effective way to reduce prices paid by commercial insurers.
Front-line stories: How today’s prior authorization processes create a burden of waste for providers
As hospitals continue to struggle with razor-thin margins, they should actively identify activities that create financial burdens for them without delivering value to patients. One health system’s stories of administrative waste due to prior authorization processes show why this activity should be be high on their list.
Navigating change: Implications of CMS’s 2021 Physician Fee Schedule
Changes to the CMS Physician Fee Schedule for 2021 require immediate deliberation by provider organizations with respect to how they will structure their physician compensation arrangements.