How a health system goes above and beyond in its price transparency efforts
By maintaining a patient-centric perspective, hospitals and health systems can find opportunities to look beyond regulatory requirements and incorporate top-class price transparency models, according to a recent online discussion. “We want to, first and foremost, empower and equip our customers to make informed decisions about their healthcare services and really shop for the best value,”…
CMS calls for hospitals to be subject to a new bundled payment model and data-reporting requirements
Notable policies in Medicare’s FY25 proposed rule for inpatient hospital care and long-term care hospitals include the formation of a mandatory bundled payment model and requirements for hospital data reporting. Although the proposed payment rate was the headlining aspect of the rule for hospitals, the policy developments could have a longer-term impact on segments of…
Hospital Prices Machine Readable File: Build vs Buy Guide
Download this guide to assist you as you run the numbers and study the facts to decide whether or not to build your own MRF(s).
BESLER provides thorough Transfer DRG revenue recovery services
Hospitals require clear and simple paths through the challenges posed by changing regulations so they can spend more time and dollars focusing on enhancing patient care.
What the Change Healthcare cyberattack means for the future of the industry
In this episode, HFMA Senior Editor Nick Hut and Policy Director Shawn Stack discuss the latest developments on the Change Healthcare cyberattack, and Joshua Corman, founder of cybersecurity organization I Am the Cavalry, shares insights on what should come next in healthcare.
Improve Patient Refunds With A Simplified B2C Payments Solution
Download this eBook to get insights into patient refunds and a solution to streamline the process for the provider while improving the patient financial experience.
Healthcare Blame Game: Patient Rights Advocate claims its report gets ‘independent review and validation’ – but does it?
Headline: The Sixth Annual Hospital Price Transparency Compliance ReportSource: Patient Rights AdvocatePublished: February 2024 PatientRightsAdvocate.org recently issued its sixth report scoring hospital compliance with federal price transparency regulations, and for the sixth time, its assessment conflicts with CMS’s assessment. I want to focus on a nugget we picked up on in the methodology section of the latest report,…
Healthcare Blame Game: Patient Rights Advocate’s distortion of price transparency regulations and data, and the ad campaign that’s catching attention
Patient Rights Advocate (PRA) has engaged hip hop artists like Fat Joe, Busta Rhymes and Method Man in its “Power to the Patients” campaign, claiming that regulations around price transparency are not being enforced, allowing hospitals to hide their prices and “charge whatever they want.” On this episode, HFMA Policy Director Shawn Stack and Ruth Lande, vice president of hospital relations at RIP Medical Debt, discuss PRA’s misinterpretation of price transparency regulations and hospital pricing.
New regulations are projected to bring providers a measure of relief from prior authorization headaches
Hospitals and other healthcare providers hailed a newly published final rule designed to improve prior authorization and the electronic exchange of health information. The Interoperability and Prior Authorization rule sets requirements for Medicare Advantage (MA) health plans, state Medicaid and CHIP programs, and Medicaid managed care organizations, all of which starting in 2026 must send…
Medicare beneficiaries would have new options for appealing their hospital patient status under a proposed rule from CMS
A proposed rule from CMS would affect the appeals process for some patients whose status is reclassified from inpatient to outpatient observation during a hospital stay. After a 2020 court ruling that was upheld at the appellate level in 2022, the U.S. Department of Health and Human Services and CMS were obligated to create additional…