HFMA

Health systems continue to invest heavily in denial management. Yet denial volumes remain stubbornly high. The reason is simple: Most organizations are still focused on addressing denials after they occur rather than preventing them in the first place. Roughly 15% of claims are initially denied, and hospitals spent nearly $19.7 billion in 2022 appealing denied…

With rising labor expenses, staffing challenges, and growing complexity in operations, leaders now look for innovative methods to maximize the benefits of workforce data and boost organizational performance. This white paper shares how to develop a workforce optimization cycle in your organization, along with insight into why it’s necessary and the risks of inaction. 

Healthcare finance leaders face a multitude of pressures, from rising operational costs and cash flow constraints to reimbursement complexities and federal funding uncertainties. When Sage partnered with HFMA last year to survey healthcare leaders about the factors influencing their finance strategies, “The results were surprising in that there’s a lot on everyone’s minds,” said Melissa…

HFMA provides a detailed summary of the rule that includes proposals to implement the provisions of the “Working Families Tax Cut” legislation, which modify the limit on the total payment rate and other requirements for State directed payments (SDPs) in Medicaid managed care with respect to certain service types and SDPs, and the proposals to expand application of the modified limit to all SDPs and all service types and to set a limit for certain targeted Medicaid payments in Medicaid fee-for-service.

Healthcare cost containment — defined as the ability to reduce healthcare costs, ranging from labor costs to operational expenses to administrative waste — remains a top priority for healthcare leaders. In fact, the ability to maintain financial stability depends on a hospital’s ability to not only improve margins, but also cut excess expense. Rising use…

Prior authorizations have entered a different era. The process has become one of healthcare’s most expensive administrative bottlenecks, affecting far more than physician practices. Across hospitals and health systems, it slows patient access, adds labor-intensive work, increases denial risk, and puts pressure on reimbursement and cash flow. For organizations focused on growth, margin, and operational…

Healthcare organizations in 2026 are operating under sustained financial strain. Margins remain compressed, workforce shortages continue, payer requirements are more complex and patient financial responsibility has increased. At the same time, many revenue cycle operations still rely on fragmented systems and manual processes that limit efficiency and delay cash flow. The traditional, reactive revenue cycle…

HFMA provides a detailed summary of the proposed rule intended to improve the electronic exchange of health care data and streamline processes related to prior authorization by increasing the interoperability of systems used across the health care industry.

HFMA presents a detailed summary of the FY 2027 Medicare inpatient prospective payment system and long-term care hospital prospective payment system proposed rule published in the Federal Register on April 14, 2026.

HFMA’s P&P Board comments on the GASB’s Proposed Implementation Guide, Financial Reporting Model Improvements-Subsidies.