Nick Hut
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Nick Hut
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Insurers see reasons for concern as CMS keeps the Medicare Advantage purse strings tight for 2025
Medicare Advantage (MA) faces the prospect of constrained revenue and payments for participating stakeholders after CMS finalized what amounts to a small decrease in the 2025 payment rate. Average revenue for MA plans is projected to increase by 3.7%, or more than $16 billion — but that’s primarily because of a prospective increase in the…
News Briefs: Providers face trying times in the first month after the Change Healthcare cyberattack
Healthcare providers struggled financially and operationally in the first 30 days after a Feb. 21 cyberattack forced the shutdown of Change Healthcare’s claims submission and payment systems, among more than 100 other applications. As of the week of March 18, parent company UnitedHealth Group had restored Change Healthcare’s payment platform and was reporting progress in…
Hospital finances are on the upswing, but the toll of the Change Healthcare outage is yet to be seen
Note: The second section of this article was updated where noted with a new comment from Fitch Ratings. There is reason to be optimistic about the state of hospital finances, but the impact of the Change Healthcare cyberattack has added uncertainty to the forecasts. Financial metrics for the first two months of 2024 continued to…
The FY24 HHS budget covers key programs for rural hospitals while tightening spending in some areas
The newly passed budget covering HHS during the remainder of FY24 contains notable provisions for healthcare providers. The roughly $117 billion departmental budget for the next six months was set in an appropriations bill that was passed by Congress and signed by President Joe Biden within hours of the March 22 expiration of funding for…
Hospitals warrant an extra boost in their Medicare payment rate next year, MedPAC says
Hospitals will get a more favorable Medicare payment increase in FY25 if Congress follows the recommendations of the Medicare Payment Advisory Commission (MedPAC). In its semiannual report to Congress, MedPAC recommended a 1.5% bump on top of what otherwise would be provided according to statute. That would mean an estimated increase of about 4.5% for…
The federal policy response to the Change Healthcare cyberattack
Note: This information is excerpted from HFMA’s running coverage of the cyberattack that disabled operations at Change Healthcare. On March 10, HHS and the Department of Labor sent a letter encouraging commercial payers to do their part to help financially strained providers nearly three weeks after the cyberattack on Change Healthcare. “Larger payers in particular…
Responses to a new RFI will help guide regulations addressing consolidation and private equity in healthcare
The Biden administration is ramping up its assessment of how to regulate consolidation and private equity (PE) acquisitions in healthcare, issuing a request for information (RFI) from stakeholders. There is a deadline of May 6 to submit comments on the RFI, which was distributed by HHS, the Department of Justice (DOJ) and the Federal Trade…
Federal funding legislation would address Medicaid DSH cuts, physician payments and more
March 8 update The Senate passed the appropriations bill by a 75-22 vote, getting it to the White House for President Joe Biden to sign hours before funding for some federal departments would have expired and a big cut to Medicaid disproportionate share hospital payments would have begun. Attention now turns to HHS and other…
Continued 340B eligibility is at risk for hundreds of hospitals thanks to pandemic-related factors
Hospitals that rely on savings from the 340B Drug Pricing Program should examine the possibility that they will soon be rendered ineligible. Several factors are having an industrywide impact on the disproportionate share hospital adjustment percentage, and if that tally drops below a certain threshold on a hospital’s Medicare cost report, the hospital cannot receive…
Cyberattack on Change Healthcare brings turmoil to healthcare operations nationwide
Resources A list of payer contacts for providers to inquire about advance payments An FAQ on Medicare accelerated and advance payments Recommendations and resources for HFMA members Link to UnitedHealth Group and Optum incident pages May 3 updates UnitedHealth Group CEO Andrew Witty on Wednesday appeared for two congressional hearings that called out some of…