How leveraging artificial intelligence in utilization management can enhance your revenue cycle
This white paper dives into how AI will help make healthcare sustainable and provide more of a focus on patient care. The goal is to decrease industry challenges and create new efforts to reduce the administrative cost of healthcare.
Billions of dollars in lump-sum payments are coming to hospitals as a remedy for 340B-related underpayments
Hospitals that participate in the 340B Drug Pricing Program stand to receive $9 billion in aggregate lump-sum payments as compensation for underpayments from Medicare during a nearly five-year period. In a proposed rule issued July 7, CMS described how it would provide remedies following a 2022 Supreme Court ruling that the U.S. Department of Health…
Denials Management Research Report
HFMA, with sponsorship from Waystar, surveyed 415 healthcare finance and revenue cycle executives to understand how denials are affecting their revenue cycle operations.
Survey reveals 5 opportunities to tackle denial prevention and management
In this survey, responses found when organizations devote greater resources to denial management than to denial prevention, their rate of first-pass denials is higher: 13.6% versus 10.9%.
The state of Medicare Advantage: As the program grows, healthcare stakeholders express concerns
As seen during a recent virtual conference, the accelerating expansion of Medicare Advantage (MA) has been accompanied by tension over growing pains such as regulatory issues. “I think MA was set up really well, but like anything else there’s sort of a moment where you have to look at the program and say: How do…
Congress seems inclined to expand site-neutral payment policies in Medicare (updated)
Momentum is building in Congress toward expanding site-neutral payment in Medicare, a move that could reduce payments to hospitals by billions of dollars per year. A recent hearing, which lasted 5 ½ hours, focused on various ideas for promoting transparency and competition in healthcare. The hearing included references to 17 bills or discussion drafts, several…
Harris Affinity Decision Support can help healthcare leaders identify meaningful areas for improvement
Improve your healthcare organization by leveraging advanced cost, performance, reimbursement and profitability data to inform and drive critical financial, operational and clinical decision-making.
How managed care contracting strategies promote operational resilience
Read this article for an in depth look on several strategic steps for healthcare leaders to take to benefit their organization's managed care contracting.
Hospitals push back against a coordinated effort to revamp the 340B program
A lobbying fight has started over the future of the 340B Drug Pricing Program, with hospitals seeking to protect what they view as an essential source of cost savings. The advocacy group 340B Health and prominent hospital associations are seeking to repel an effort led by the Pharmaceutical Research and Manufacturers of America (PhRMA) to…
The media blame game regarding patient financial conversations
Brad Dennison, HFMA chief content executive, discusses the March hfm cover story about patient-friendly payment and what some media organizations get wrong.