Medicare’s hospital outpatient payment rate for 2024 improves marginally from the proposed rule
The final rule setting Medicare’s 2024 payment rates and policies for hospital outpatient services and ambulatory surgical centers (ASCs) contained no major surprises and little to make hospitals optimistic about the government portion of their payer mix. Here are five of the most important payment and coverage takeaways from the rule, which totals 1,672 pages…
Medicare’s final $9 billion remedy plan for 340B providers doesn’t address hospitals’ key concerns
Hospitals received final details on a $9 billion remedy payment plan for participants in the 340B Drug Pricing Program, with advocates expressing disappointment that corresponding reductions to other payments will go through as previously proposed. CMS issued a Nov. 2 final rule describing the terms of the remedy payment, which was necessitated after the Supreme…
With No Surprises Act independent dispute resolution changes pending, provider reps voice systemic concerns
The No Surprises Act’s arbitration process continues to be hampered by parties that don’t always follow the regulations, stakeholders expressed to CMS on Thursday. The agency hosted a forum to describe changes being made to the arbitration process, also known as independent dispute resolution (IDR). A proposed rule issued Oct. 27 introduces various technical changes…
HRSA curtails pandemic-era 340B flexibilities for hospitals’ off-campus outpatient facilities
In an expected move that stands to affect the savings reaped by health systems from the 340B Drug Pricing Program, the Health Resources and Services Administration (HRSA) is tightening participation requirements for off-campus outpatient facilities. In a published alert, HRSA announced plans to end pandemic-related flexibilities that have made it easier for off-campus outpatient facilities…
Hospital, physician advocates disagree over the role of physician-owned hospitals as policymakers ramp up focus
Hospital advocacy groups hope to stanch momentum that’s building in policy circles to increase the number of physician-owned hospitals. The American Hospital Association (AHA) and Federation of American Hospitals (FAH) issued a joint statement Oct. 18, saying permitting greater numbers of physician-owned hospitals (POHs) would have adverse effects on healthcare costs, access and quality. The…
In response to a congressional RFI, provider advocates give input on ways to bolster rural healthcare
Hospital and physician groups were among the respondents to a request by a key congressional committee for information on improving rural healthcare. In an RFI issued in September, the House Ways and Means Committee sought policy solutions for augmenting access to — and the quality of — healthcare in relatively remote areas. “The committee will…
Amid positive signs financially, hospitals continue to grapple with high costs in labor and other areas
The latest financial metrics for the hospital sector reflect a period of increasing stability but also sustained challenges. August financial data from more than 1,300 hospitals, as reported by Syntellis Performance Solutions, showed improvements in key metrics. The month-over-month increase in median operating margin was 3.5 percentage points, helping the year-to-date margin rise to 1.4%…
Healthcare News of Note: Telehealth visits are more often coded with a lower billing code than in-office visits
Over the past few weeks, I have found these industry news stories that should be of interest to healthcare finance professionals. 1. Telehealth visits are more often coded with a lower billing code than in-office visits “For both primary and specialty care, telehealth visits are more frequently coded with a lower level-of-service billing code than…
Hospitals push back on Senate report that calls out lack of spending on charity care
Not-for-profit (NFP) hospitals continue to be the subject of congressional scrutiny, with the chair of a key Senate committee issuing a report that questions whether they provide levels of charity care that are commensurate with their tax exemption. The report was released Oct. 10 by Senator Bernie Sanders (I-Vt.), chair of the Senate Health, Education,…
Healthcare labor union activity gains steam: The consequences for hospitals and health systems
Note: The lead section of this article was updated Oct. 16 with news of a tentative agreement between Kaiser Permanente and the unions. When around 75,000 staff at Kaiser Permanente went on strike for three days starting Oct. 4, they represented more than just the largest-ever labor stoppage in the healthcare industry. They also exemplified…