Hospital operational changes underway as health equity becomes one of The Joint Commission’s National Patient Safety Goals
Reducing healthcare disparities became a Joint Commission accreditation standard (LD.04.03.08) on Jan. 1, a little more than a year after the organization issued a Sentinel Event Alert warning of impacts on patient safety. However, on July 1, the standard will become a National Patient Safety Goal (NPSG), which experts say points to one thing: Healthcare…
CMS and other stakeholders take steps to improve prior authorization in Medicare Advantage and beyond
Several recent developments point to an industrywide effort to ease the burden of prior authorization. Most notably, CMS on April 5 finalized a rule that includes provisions designed to improve prior authorization in Medicare Advantage (MA) starting with the 2024 plan year. The rule addresses a few aspects of prior authorization, among them the way…
HFMA Names Ann Jordan as New CEO
The Healthcare Financial Management Association (HFMA) announced today that its board of directors has unanimously chosen Ann Jordan as the organization’s next president and chief executive officer, effective June 6, 2023. She will be the first female CEO in HFMA’s 77-year history. Jordan currently serves as CEO of ASQ, a global membership association for quality professionals with members in more than 130 countries.
Healthcare Blame Game: How news outlets mishandled a medical debt study
Brad Dennison is a 25-year veteran of the newspaper industry. He served 15 years as the top news executive for multiple national organizations and led thousands of journalists across the U.S., including investigative teams. He’s also a past board member of the Associated Press Media Editors, where he was elected national chair. Dennison joined HFMA…
Court decision means cost sharing could be reinstated for some preventive healthcare services
Comprehensive coverage of some preventive care services could be jeopardized by a recent court ruling. Since its passage, the Affordable Care Act (ACA) had required health plans to cover the full cost of services that received an “A” or “B” rating from the U.S. Preventive Services Task Force (USPSTF). A federal judge in Texas ended…
Maryland’s all-inclusive population health payment model continues to show promise, but nonhospital spending poses a concern
An innovative payment model for Maryland healthcare providers has improved utilization, cost and quality thus far, but an increase in nonhospital spending requires further study. The Center for Medicare & Medicaid Innovation (CMMI) released an analysis of the first three years of Maryland’s Total Cost of Care Model, an effort to improve population health management.…
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…
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…
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…