HFMA CEO Jordan, healthcare leaders point to urgency of affordability challenges during ViVE conference
There’s an urgency to address healthcare affordability, panelists at a ViVE conference presentation Tuesday, Feb. 24, agreed — and the need for action is driving bold, collaborative ventures among leaders in healthcare, health tech and private equity. “I think the clock’s really ticking for real now,” said Marcus Whitney, founding partner of Jumpstart Health Investors. “I don’t think anyone cares to protect incumbents anymore, so…
Risk-pay diverges by payer
The share of payments that include downside risk increased in traditional Medicare and Medicare Advantage (MA) but dipped in Medicaid and commercial insurance. Those findings were included in the annual tracking of payer risk that AHIP took over last year from the Health Care Payment Learning & Action Network (HCP-LAN), which had tracked it since…
How CareCloud is modernizing MAP App to elevate revenue cycle insights and performance
MAP App was developed by HFMA for credible measurement of revenue cycle performance, ensuring apples-to-apples benchmarks across peer groups and actionable opportunities. While CareCloud now owns the application, MAP App benchmarks, MAP Keys and insights continue to be driven by HFMA’s trusted standards, ensuring an objective view of performance regardless of the systems an organization uses.
How a looming federal mandate will affect hospitals
Nick and Shawn discuss appropriations efforts and how various provisions will affect hospitals, specifically in outpatient department claims. Note: After the recording of this episode, the parties hit a roadblock on the bill that was the main topic of discussion. Check out our news coverage for the latest.
Hospitals hope litigation will stop the 340B rebate model before it gets started
Hospitals are going to court in an effort to thwart major changes to the 340B Drug Pricing Program. The American Hospital Association (AHA) was among a group that filed a lawsuit against the federal government Dec. 1, seeking to have implementation of a planned 340B rebate model halted before it begins Jan. 1. Under the…
340B rebate model is set to proceed in 2026 with 9 drugs
A new chapter for the 340B Drug Pricing Program will begin Jan. 1 after the Health Resources and Services Administration (HRSA) formally authorized a rebate model last week. For 2026, eight approved manufacturers can provide rebates rather than upfront discounts to 340B participating providers dispensing nine drugs: The list of drugs for the rebate model…
OIG report could lead to additional inspection of hospitals’ Provider Relief Fund usage
Some hospitals that received funding support from HHS during the COVID-19 pandemic may need to prepare for additional auditing based on findings of a report by the department’s Office of Inspector General (OIG). The report examined a small sampling of Provider Relief Fund (PRF) recipients and found that 17 of 25 hospitals did not comply…
Hospital financial metrics remain steady even as costs rise and reimbursement challenges await
The latest data on financials for the not-for-profit (NFP) hospital sector hints at the challenges in store. While margins have not taken a significant hit for health systems, other metrics reflect rising costs, according to the latest monthly report from Strata Decision Technology. Beyond that immediate concern is the prospect of reduced reimbursement not only…
Proposed 340B rebate model generates an array of concerns among providers
Hospital advocates are pushing back on a fast-approaching rebate model for the 340B Drug Pricing Program, while a new Congressional Budget Office (CBO) report illustrates the accelerating spending in the program. The Health Resources and Services Administration (HRSA), which administers 340B, previously announced that a pilot program to test the application of a rebate model…
The hospital tax exemption comes under scrutiny in Congress
At a time when concerns over reimbursement and costs already are intensifying, Congress recently held a hearing to discuss policy changes that could exert further pressure on the not-for-profit (NFP) hospital sector. A subcommittee of the House Ways and Means Committee met Sept. 16 to examine the NFP hospital tax exemption, soliciting proposals that could…