Financial Sustainability Report: July 2021
The July 2021 issue of the Financial Sustainability Report, sponsored by Kaufman Hall, includes an account of how one health system assessed the benefits and risk associated with moving its 340B covered-entity pharmacy enterprise to a Limited Liability Company. The issue also includes a commentary on CMS’s new Acute Hospital Care at Home program and a discussion of a new metric, equivalent net patient revenue (ENPR), which organizations can use to assess the relative value of proposed investments in alternative revenue sources.
Study establishes a link between surges in COVID-19 cases and risk of mortality at hospitals
Statistical analysis shows nearly a quarter of COVID-19 deaths during the first six months of the pandemic could be ascribed to high caseloads at hospitals.
In 2022 OPPS rule, CMS plans to reinstate policies pertaining to the inpatient-only and ASC covered-procedures lists
The 2022 proposed rule for the Outpatient Prospective Payment System would reverse 2021 policies that began to phase out the inpatient-only list of procedures and expand the covered-procedures list for ambulatory surgical centers.
Healthcare News of Note: National index shows denials are up 11% since the onset of COVID-19
Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Denials are up since the onset of COVID-19, nonprofit hospitals’ community investing falls short, and pediatric clinicians use the EHR less than other clinicians.
Surveys show rates of uninsured increased, underinsured remains significant
HFMA's Chad Mulvany says healthcare organizations should ensure their self-pay revenue cycle process follows best practices as it’s likely with more people uninsured there will be increased scrutiny of these processes.
Healthcare providers face challenges implementing the latest Surprise Medical Billing Interim Final Rule
HFMA’s Shawn Stack reviews the key provider challenges introduced by the IFC interim final rule with comment period (IFC) that implements sections of the federal ban on surprise medical bills.
Healthcare News of Note: 23% of COVID-19 patients have a post-COVID symptom 30 days after first being diagnosed, large study finds
Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Top symptoms affecting long-haul COVID-19 patients, positive findings about patient experiences at HOPDs and ASCs, and a survey showing favorable physician attitudes regarding telemedicine.
A closer look at the new surprise billing regulations: How cost sharing will be calculated
The qualifying payment amount that establishes a patient's cost sharing for out-of-network care also is intended to factor into negotiations between providers and health plans regarding payment.
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.
A closer look at the new surprise billing regulations: The impact on balance billing
New regulations on surprise billing will affect hospital billing processes starting in 2022.