4 bipartisan healthcare policy changes are likely in 2025
HFMA policy experts see a high likelihood for far-reaching changes in healthcare policy following the November elections, with a focus on four areas: site-neutral payments, prior authorization, the 340B Drug Pricing Program, and mergers and acquisitions (M&A). The elections could produce a range of outcomes for the presidency and control of Congress. However, strong bipartisan…
How PFC USA’s solutions can help boost revenue and patient satisfaction
Learn how to address challenges in the healthcare industry such as rising costs and strict regulations with advice on managing regulatory compliance and enhanced patient engagement, among other ways to lead organizations to success.
Offering a health and wellness credit card provides a patient-friendly payment option
Learn about a patient financing solution that helps reduce accounts receivable and provides financing options so patients can seek out the care they want or need.
Create more accurate cost reports faster with BESLER’s Easy Work Papers
A cost report is a critical reimbursement tool, but as much as 80% of it is repetitive. Check out this solution that is designed to help hospitals automatically complete the areas that repeat, so their staff has more time to focus on areas that have a real impact on the hospital’s revenue.
New rules have program integrity implications for Medicare, Medicaid stakeholders
CMS in recent days issued a pair of final rules designed to improve aspects of program integrity in Medicare and Medicaid. The Medicare rule was published Sept. 27 and finalized proposals that were published in early July after CMS became aware of significant potential billing fraud involving a specific type of urinary catheter. Premier, Inc.,…
FTC takes legal action against pharmacy benefit managers, citing a distorted drug-pricing structure
A growing dispute between pharmacy benefit managers (PBMs) and government regulators intensified Sept. 20 when the Federal Trade Commission (FTC) filed suit against the three leading PBMs and their affiliated group purchasing organizations (GPOs). The complaint against CVS Caremark, Express Scripts, Inc. (ESI, owned by Cigna) and OptumRx (UnitedHealth Group) seeks to address a system…
Reports on healthcare labor trends indicate an improved outlook for hospitals
The labor picture continues to stabilize for hospitals even amid sustained high demand for healthcare services, according to new insights. In its latest labor tracker, Fitch Ratings reported that hospital staff payrolls have been steadily expanding and now represent a 6.7% increase relative to the pre-pandemic month of February 2020. Hospitals added 18,650 jobs per…
MedPAC starts to scrutinize the costs of outpatient coinsurance at critical access hospitals
At the nation’s nearly 1,400 critical access hospitals (CAHs), cost-sharing payments incurred by Medicare beneficiaries for outpatient services are onerous enough that a new methodology warrants consideration, according to a recent policy discussion. The Medicare Payment Advisory Commission (MedPAC) examined the issue at its September meeting, reporting that beneficiary coinsurance for CAH outpatient care equates…
Senate hearing on Steward Health Care depicts consequences of hospital management decisions (updated-2)
Note: This story was updated Sept. 26 and Sept. 30 with additional news, including a lawsuit filed by now-former CEO Ralph de la Torre. After the CEO of Steward Health Care rebuffed a subpoena to appear Thursday at a Senate committee hearing, members and invited panelists used the occasion to bemoan the company’s hospital ownership…
New federal rule means big changes in coverage of behavioral healthcare
Landmark regulations issued by the Biden administration are intended to establish coverage parity for behavioral healthcare services. A newly published final rule prohibits group health plans, along with health insurers offering group or individual insurance coverage, from restricting access to mental-health and substance-use disorder (SUD) benefits as compared with medical and surgical benefits. The rule,…