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Data + Insights
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- Guidehouse Payvider
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- GuideIQ, powered by Guidehouse
- Harness Price Transparency with Turquoise Health
- HFMA Health System Purchase Plans 2023
- HFMA Health System Purchase Plans 2023
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Shawn Stack
About the Author
Shawn Stack
Latest Work
American providers remain in reimbursement limbo during IDR failure
HFMA and its member healthcare providers are growing more concerned over the extended delay of reimbursement from group health plans subject to the unresolved No Surprises Act IDR regulations and guidance. HFMA members continue to report that numerous health plans persist in determining very low rates for calculating the Quality Performance Assessment (QPA) they are…
Patient Rights Advocate continues to misinterpret price transparency data with latest report
Once again, Patient Rights Advocate (PRA) has issued a report that misrepresents compliance with CMS price transparency regulations. (Read my March blog about a previous PRA report here.) PRA’s most recent “Hospital Price Transparency Compliance Report,” published in July, examines websites of 2,000 U.S. hospitals. Its findings were that only 36% of those hospitals fully…
Navigating Medicare’s 2024 inpatient payment rule
On Aug. 1, 2023, CMS published its final rule for federal FY24 inpatient prospective payment system (IPPS). Undoubtedly, navigating such complexity in a healthcare rule can be quite challenging. The purpose of this blog post is to provide some much-needed clarity regarding the new rule, enabling healthcare finance leaders to direct their attention towards the…
Medicare’s proposed remedy for 340B-acquired drug underpayments: Addressing only half at best?
On July 7, 2023, CMS released a proposed rule, identified as CMS-1793-P, which outlines the agency’s intended actions to address the adjustment of Medicare payment rates for drugs acquired under the 340B Drug Pricing Program. This proposed rule pertains to the period spanning from calendar year 2018 through Sept. 27, 2022. The necessity for this remedy…
PatientRightsAdvocate.org misinterprets CMS rules in low estimate of hospital price transparency compliance
In February, PatientRightsAdvocate.org (PRA) published its Fourth Semi-Annual Hospital Price Transparency Report, which states that only 24.5% of hospitals are compliant with federal price transparency regulations. This is a vast contradiction of CMS’s own compliance findings, which show 70% overall compliance during the same timeframe, as published in a Health Affairs blog on Feb. 14.…
Shawn Stack: No Surprises Act is important move toward meaningful consumer transparency
The No Surprises Act, which became effective on Jan. 1 of 2022, will clearly benefit patients, .ut its larger impact is yet to be seen as the industry awaits the release of provisions targeting health plans and payers.
Hospitals sort through the last 18-plus months to report expenses and lost revenue on a pandemic that is not over
Providers should develop a strategy for PRF portal reporting early on and account for all expenses and loss of revenue to maximize PRF distributions.
Hospital care at home signifies an important innovation in acute care delivery
Although the CMS Acute Hospital Care at Home program is still early in its development in the U.S., early adopters show evidence of the program’s exciting promise, including positive impacts on health outcomes, an improved patient and provider experience, reduced cost of care and overall healthcare savings.
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 leaders offer direction on key CMS inpatient proposals for FY 2022
HFMA offers direction to CMS on several of its key inpatient proposals for 2021 as many healthcare leaders have expressed concern about these proposals.