Is This the Age of the Payvider?
By now, most health systems are familiar with the term payvider, and many are weighing the pros and cons of initiating their own payvider solution. The critical tipping point to act may well be here today, as health systems feel increased pressure to make greater financial and strategic impact for their organizations even as conditions…
Healthcare News of Note: Providers in these 10 states may struggle the most to collect claims from payers
Over the past few weeks, I have found these industry news stories that should be of interest to healthcare finance professionals. 1. The top and bottom states for paying provider claims are detailed in new report “A connection exists between where a provider operates and how fast and accurately claims are paid,” according to a…
The 5 provider strategies to improve profit margins
Improving financial performance and operating margins has become one of the most pressing concerns for health system CEOs. To meet future margin targets, leaders will have to bring a new level of focus, resources and structure to achieve deeper cost reductions on a recurring basis. At the same time, this is critical to ensuring that…
How to staff smarter and reduce reliance on expensive travel contracts
To bridge the healthcare staffing gap and tackle workforce issues such as burnout, spikes in labor costs, and rising retirements among nurses, hospitals and healthcare facilities need a technology-driven approach that empowers staffing managers with the control needed to address fluctuating patient volume without understaffing or overspending on labor. This How-To guide highlights the challenges,…
Rising specialty medication costs: The urgent need for innovative payment models in healthcare
How alternative payment models can make drug spend more predictable Plan sponsors are facing rising and volatile drug spend, largely driven by high cost specialty medications. While they often account for less than 2% of all claims, these drugs can represent more than 50% of total spend. This challenge is likely to get worse. As…
5 things to know about Medicare’s FY24 final rule for inpatient payments as hospitals foresee adverse impacts
The FY24 final rule for Medicare inpatient payments didn’t bring hospitals the type of rate update they sought, and for some organizations a bigger concern is changes to uncompensated care (UC) payments and disproportionate share hospital (DSH) payments. Here are five big points about the regulations, which take effect Oct. 1 and also cover Medicare…
The latest on hospital finances: Signs of improvement, but margins remain tight
Industry-level hospital financial insights reflect the mixed results of a recovery that’s in progress but is expected to be a long slog. In a 2023 midyear report (login required), Moody’s Investors Service noted that margins are below 3% for a third of the company’s rated hospitals. Before the pandemic, only about 6% had margins in…
A projected Medicare physician payment decrease spurs more calls to reform the system
Physician advocacy groups vehemently expressed concern about the financial consequences of CMS’s proposed rule for Medicare physician payments in 2024, intensifying a push to modify the payment system. At a time of elevated expenses in healthcare, total payments would be reduced by a projected 1.25% relative to 2023. That would follow a 2% decrease from…
Annual Conference: Healthcare entrepreneur Alex Oshmyansky describes his efforts to disrupt drug pricing
Arguably no segment of the healthcare industry is more susceptible to disruption than the market for prescription drugs, as Alex Oshmyansky, MD, PhD, made clear Wednesday morning during the closing session of HFMA’s Annual Conference. Oshmyansky spoke about his personal efforts to disrupt the pharmaceutical market in his role as co-founder and CEO of Mark…
David Johnson: The orthopod’s dilemma — Caught between the PE rock and the venture capital hard place
The OrthoForum is the premier convening and advocacy organization for large, independent orthopedic physician groups. In March 2022, I gave a keynote address at The OrthoForum’s Annual Conference in Orlando, Florida. Attending the conference at the posh Grande Lakes Ritz-Carlton gave me a front-row seat to the economic forces reshaping orthopedic care delivery in the…