Payment Trends

Why responding to site-neutral payment risk is imperative for hospitals and health systems

As the likelihood of site-neutral payments increases over a range of services, hospitals and health systems must understand which services are most at risk from these changes and determine how quickly they will respond.

Dawn Samaris, MBA September 27, 2021

Provider conduct could have a big impact on the future of telehealth, experts say

Widespread certification for telehealth could encourage policymakers to retain the waivers that have promoted expanded virtual access, industry experts say.

Nick Hut August 19, 2021

Study: In price negotiations with hospitals, self-insured employers lack leverage

The vast difference in market power between hospitals and employers leaves the latter group with little recourse in negotiations, according to a new study.

Nick Hut July 29, 2021

Hospital care at home signifies an important innovation in acute care delivery

Although the CMS Acute Hospital Care at Home program is still early in its development in the U.S., early adopters show evidence of the program’s exciting promise, including positive impacts on health outcomes, an improved patient and provider experience, reduced cost of care and overall healthcare savings.

Shawn Stack July 23, 2021

Moving a 340B covered entity’s pharmacy enterprise to an LLC may prove beneficial, but it requires a feasibility study

University of Utah Hospitals and Clinics (UUHC) in Salt Lake City performed research to assess the feasibility of moving its 340B covered-entity pharmacy enterprise to a Limited Liability Corporation (LLC), with a focus on risks that should be factored into the decision. Other organizations that are considering such a move could benefit from adopting UUHC’s assessment approach.

Nathan Hagen, PharmD, MS July 21, 2021

Healthcare News of Note: Few consumers are using publicly posted negotiated prices to comparison shop for healthcare services

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Little use of price transparency information to comparison shop for healthcare services, the nursing shortage being felt throughout the U.S., and cash payers being charged more for the same services than patients with insurance.

Deborah Filipek July 9, 2021

Medicare should update its policies for separately payable drugs in the Outpatient Prospective Payment System, MedPAC says

Worthwhile changes include requiring drugs to be proven clinically superior before granting them pass-through payment status, according to a new report.

Nick Hut June 27, 2021

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

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

6 takeaways from HFMA’s Cost Effectiveness of Health Summit: Why health spending must become more cost-effective

HFMA’s first Cost Effectiveness of Health Summit drove home the urgency of improving how healthcare dollars are spent.

Nick Hut May 13, 2021
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