Reports on patient safety indicate progress, challenges and a need to focus on pediatric mental health
Recent reports add context to the issue of patient safety in hospitals and health systems. ECRI released a report that ranks the pediatric mental health crisis as the No. 1 patient safety issue in healthcare. The report cites a JAMA study that found increases of 29% in anxiety and 27% in depression between 2016 and…
Creating sound strategies to manage compensation and benefits regardless of where your employees reside
No doubt there are significant cultural and financial benefits to supporting continued remote and hybrid work in healthcare, particularly in billing/coding, call center, scheduling and administrative roles. Healthcare, however, faces specific challenges as they seek to demystify multi-state tax rules.
Meeting healthcare’s workforce challenges requires innovation — with a dose of humanity
There is no low-hanging fruit left in workforce innovation. Yet hospital and health system finance executives who are looking for investments their organizations can make to reach higher up the tree should not be deterred. They can follow the lead of health systems that have already taken risk and reaped rewards — from taking an…
Member spotlight: Reaching out to learn and lead are hallmarks of Nimisha Madhu’s approach to revenue cycle management work
Nimisha Madhu enjoys exploring and learning about new areas in revenue cycle management (RCM) and then using her knowledge to deliver positive outcomes to her co-workers. Madhu, billing and recovery officer at Sheikh Shakhbout Medical City (SSMC) in Abu Dhabi, recently shared with HFMA’s International Update how she is using her HFMA international membership to…
Hospitals push back against a coordinated effort to revamp the 340B program
A lobbying fight has started over the future of the 340B Drug Pricing Program, with hospitals seeking to protect what they view as an essential source of cost savings. The advocacy group 340B Health and prominent hospital associations are seeking to repel an effort led by the Pharmaceutical Research and Manufacturers of America (PhRMA) to…
New guidance for No Surprises Act arbitration looks like an improvement for providers
Responding to a recent court ruling, the U.S. Department of Health and Human Services (HHS) has updated the application of criteria for deciding No Surprises Act (NSA) independent dispute resolution (IDR) cases. Certified IDR entities (i.e., arbitrators) received guidance March 17 instructing them to more directly consider multiple factors when deciding on an out-of-network payment…
How to determine appropriate patient status and navigate observation-level care
The financial implications of ensuring appropriate patient status throughout a hospital stay are substantial, so it is in organizations’ interest to enhance the process.
Here comes the Medicaid unwinding: The healthcare industry braces for coverage disruptions
A potentially tumultuous period for revenue cycle teams in particular and the U.S. healthcare system in general begins April 1, with the phasing out of a three-year run of Medicaid continuous enrollment. The so-called Medicaid “unwinding” originally was connected to end of the COVID-19 public health emergency (PHE), which is scheduled for May 11. But…
Data capture and coding for social determinants of health are works in progress, per reports
In the effort to bring social determinants of health (SDoH) more under the purview of healthcare providers, one tricky aspect is establishing a data and coding infrastructure. Recent reports highlight this challenge. For example, a survey conducted for the American Health Information Management Association (AHIMA) found that although 78% of 2,637 respondents said their organizations…
Navigating payer practices to reduce denials and enhance outcomes
The friction between payers and providers has existed for decades. It’s understandable to an extent. Payers want to reduce expensive and unnecessary treatment, eliminate fraud and lower financial risk. Providers want to be able to make decisions regarding their patients’ care without having to navigate the hurdles of medical necessity, prior authorization and complex payer…