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Health Plan Payment and Reimbursement
A provider association that earlier won a lawsuit over the No Surprises Act arbitration process is going to court again over the same issue.
By Nick Hut
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Healthcare Business Trends
The American Hospital Association and hospital leaders say recent financial trends are unsustainable for many organizations.
By Nick Hut
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Medicare Payment and Reimbursement
As published in hfm magazine, a monthly roundup of top news for healthcare finance professionals.
By Nick Hut
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Healthcare Business Trends
Even as much of society takes steps toward pre-pandemic normalcy, hospitals continue to struggle under the weight of the last two and a half years.
By Nick Hut
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Health Plan Payment and Reimbursement
A new final rule codifies updated criteria for deciding arbitration cases under the No Surprises Act, with providers potentially coming out ahead relative to last year’s interim final rule.
By Nick Hut
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Medicare Payment and Reimbursement
Newly signed legislation gives Medicare authority to negotiate the prices of certain high-cost drugs with manufacturers.
By Nick Hut
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Strategic Planning
Amazon’s announced purchase of One Medical for nearly $4 billion should spur providers to fortify their primary care strategies.
By Nick Hut
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Medicare Payment and Reimbursement
The final rule for Medicare inpatient payments to acute care hospitals calls for a 4.3% increase, up by more than a percentage point from the proposed rule.
By Nick Hut
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Revenue Cycle Technology
For hospitals and health systems, survey results show that the ongoing labor crunch in revenue cycle operations has provided an impetus to expand process automation.
By Nick Hut
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Cost of Care
Consumer-focused inflation numbers aren’t as significant in healthcare as in other sectors, but prices are hampering hospitals and health systems.
By Nick Hut
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Medicare Payment and Reimbursement
Even before factoring in the impact of the 340B payment changes, hospital groups aren’t happy with the proposed payment update.
By Nick Hut
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Healthcare Business Trends
Educational content at HFMA’s 2022 Annual Conference featured timely insights on the most pressing financial and operational issues facing healthcare organizations.
By Nick Hut
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Medicare Payment and Reimbursement
Medicare physician payments would decrease by more than 4% in 2023, according to a proposed rule.
By Nick Hut
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Medicare Compliance RAC OIG
Seeking to shore up operations for rural hospitals, CMS issued a proposed rule that establishes recommended regulations for the new rural emergency hospital category.
By Nick Hut
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Partnerships and Value
Karen DeSalvo was honored with HFMA’s Board of Directors award, while keynote speaker Joel Selanikio discussed the potentially seismic impact in healthcare as the consumerization of technology accelerates.
By Nick Hut
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Financial Leadership
New HFMA Chair Aaron Crane spoke about why healthcare stakeholders must ignite the spark to make way for a better system, while a keynote speaker discussed how to channel a warrior spirit.
By Nick Hut
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Cost Effectiveness of Health
Healthcare stakeholders must embrace a broader concept of health to enhance the welfare of their communities, according to a pair of talks Monday at HFMA’s Annual Conference.
By Nick Hut
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Innovation and Disruption
The U.S. healthcare industry is undergoing a reframing to correct glaring problems, said clinical executive Zeev Neuwirth during the opening keynote presentation of HFMA’s 2022 Annual Conference.
By Nick Hut
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Revenue Cycle
Twenty-seven organizations received the 2022 MAP Award during the opening general session of HFMA’s Annual Conference.
By Nick Hut
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Medicare Payment and Reimbursement
In separate cases, the Supreme Court said HHS’s formula for determining DSH payments is statutorily correct and that health plans can limit outpatient dialysis coverage.
By Nick Hut
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Price Transparency
The federal price transparency requirements for hospitals entered a new phase this month, with CMS not only issuing the first fines for noncompliance but also publicizing those penalties.
By Nick Hut
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Medicare Payment and Reimbursement
In a 9-0 ruling, the Supreme Court said CMS didn’t have the authority to lower drug reimbursement amounts for 340B hospitals as it did in 2018 and 2019.
By Nick Hut
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Medicare Payment and Reimbursement
Even though the Hospital Insurance Trust Fund now is expected to be depleted in 2028 instead of 2026, Medicare still faces daunting challenges.
By Nick Hut
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Capital Sources and Allocation
Recent feedback from HFMA members signals that healthcare finance and administrative operations have returned to something closer to normal in recent months.
By Nick Hut
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Healthcare Business Trends
A leading credit-rating agency says the not-for-profit hospital sector will face significant headwinds for the rest of this year and beyond.
By Nick Hut
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Labor Cost Management
As published in hfm magazine, a monthly roundup of top news for healthcare finance professionals.
By Nick Hut
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Pricing
Newly issued reports and policy recommendations are examining hospital prices in the context of high healthcare costs.
By Nick Hut
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Strategic Planning
The struggles of smaller providers amid the COVID-19 pandemic are likely to give way to increased merger-and-acquisition activity in 2022, according to Wall Street analysts.
By Nick Hut
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Healthcare Business Trends
Hospital financial performance partially recovered in March as patient volumes returned to something closer to normal after a significant downturn during the omicron wave.
By Nick Hut
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Health Plan Payment and Reimbursement
The portal for payment arbitration cases taking place under the No Surprises Act is open for business but could be facing a backlog of cases.
By Nick Hut
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Strategic Partnerships Mergers and Acquisitions
Merger-and-acquisition activity among hospitals and health systems remained well under pre-pandemic levels in Q1 2022.
By Nick Hut
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Medical Debt
A monthly roundup of top news for healthcare finance professionals.
By Nick Hut
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Medicare Payment and Reimbursement
The hospital industry expressed disappointment with the proposed increase for inpatient payments in FY23.
By Nick Hut
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Medicare Payment and Reimbursement
CMS mostly finalized previously proposed criteria for coverage of Aduhelm, which has been promoted as the first drug to treat the underlying pathology of Alzheimer’s disease.
By Nick Hut
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Coronavirus
Concerns about the implications of deferred care continue to grow as healthcare organizations establish their strategies for a post-pandemic landscape.
By Nick Hut
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Revenue Cycle
5 takeaways from HFMA’s Revenue Cycle Conference
By Paul Barr
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Coronavirus
A bipartisan Senate bill would pay for additional vaccines and therapeutics but wouldn’t restore funding to a program that reimburses providers for furnishing COVID-19-related services to the uninsured.
By Nick Hut
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Cost of Care
A monthly roundup of top news for healthcare finance professionals.
By Nick Hut
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Coronavirus
Healthcare organizations that received Provider Relief Fund payments between July 1 and Dec. 31, 2020, have until Thursday, March 31 to report on their use of those funds.
By Nick Hut
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Medicare Payment and Reimbursement
CMS shouldn’t increase Medicare payments to hospitals for the upcoming year beyond the annual update that is based on current law, according to the Medicare Payment Advisory Commission.
By Nick Hut
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Coronavirus
Claims submitted to HRSA’s COVID-19 funds for uninsured and underinsured patients soon won’t be paid
Funds used to reimburse providers for supplying COVID-19-related services to the uninsured and underinsured will expire soon if Congress doesn’t act.
By Nick Hut
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Payment Reimbursement and Managed Care
An FY22 appropriations bill allows hospitals to remain in the 340B Drug Pricing Program if their eligibility had been adversely affected by the COVID-19 pandemic.
By Nick Hut
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Revenue Cycle
Revenue cycle management is the process used by healthcare systems to track the revenue from patients, from their initial appointment or encounter with the healthcare system to their final payment of balance. The most effective revenue cycl...
By Jennifer Williams
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Accountable Care Organizations
CMS's overhaul of the Direct Contracting program draws praise from supporters of value-based payment
Value-based payment advocates see reason for optimism in CMS’s recent decision on the future of its Direct Contracting model.
By Nick Hut
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Pricing
Recent price increases have been slower in healthcare than in the economy at large, but two healthcare economists say the long-term price trends should be addressed through regulation.
By Nick Hut
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Coronavirus
A roundup of top news for healthcare finance professionals.
By Nick Hut
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Billing and Collections
A federal judge found in favor of the Texas Medical Association in a case about the arbitration process that is being implemented as part of the No Surprises Act.
By Nick Hut
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Cost of Care
Bringing longer stays and higher rates of deferred care, the COVID-19 pandemic is adversely affecting 340B eligibility for some hospitals.
By Nick Hut
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Value-Based Payment
Medicare’s Direct Contracting model, touted as representing the evolution of alternative payment models, could be shelved less than a year after getting started.
By Nick Hut
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Medicare Payment and Reimbursement
Medicare Part D and Medicare Advantage could be prime targets as Congress seeks to shore up the Hospital Insurance Trust Fund before it becomes insolvent in 2026 as projected.
By Nick Hut
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Coronavirus
A roundup of top news stories for healthcare finance professionals.
By Nick Hut
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Cost of Care
Latest healthcare spending data paint a complicated picture of industry challenges and opportunities
Healthcare spending patterns during the first year of the COVID-19 pandemic reflect an industry trying to get its bearings amid a public health emergency and daunting long-term trends.
By Nick Hut
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Labor Cost Management
The hospital industry issued its latest plea for additional federal help to mitigate the financial and operational strain of COVID-19, including surging staffing costs.
By Nick Hut
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Strategic Partnerships Mergers and Acquisitions
The year 2021 was one of the least busy on record for healthcare mergers and acquisitions, but volume should pick up in 2022.
By Nick Hut
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Coronavirus
The court lifted injunctions that had halted implementation of the COVID-19 vaccine mandate in half the country, leaving hospitals and other affected providers with likely only a few weeks to begin complying.
By Nick Hut
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Labor Cost Management
As highlighted in new employment data and new studies, the healthcare labor market continues to constrain hospitals.
By Nick Hut
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Billing and Collections
With new surprise billing regulations in place, providers should seek to implement efficient processes for gauging whether a patient is in-network.
By Nick Hut
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Coronavirus
The status of the COVID-19 vaccine mandate for healthcare workers took another twist, with CMS stating it will look to enforce the mandate within a month in 25 states and Washington, D.C.
By Nick Hut
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Coronavirus
The Biden administration announced several provisions to bolster hospitals as efforts to contain the COVID-19 pandemic enter a third calendar year.
By Nick Hut
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Artificial Intelligence
HFMA’s most recent Outlook Survey of healthcare finance professionals highlights the potential of technology to usher in big changes in upcoming years.
By Nick Hut
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Coronavirus
The nation’s highest court is being asked to clarify whether implementation of CMS’s COVID-19 vaccine mandate can proceed.
By Nick Hut
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Patient Financial Communications
Providers have had a mere three months to implement the processes needed to comply with a new requirement to provide uninsured patients with good-faith estimates in advance of services.
By Nick Hut
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Coronavirus
The question of whether healthcare employees can be covered by vaccine mandates likely will be decided by the Supreme Court.
By Nick Hut
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Coronavirus
Provider Relief Fund Phase 4 payments will be made starting Dec. 16 to providers that applied and were deemed eligible.
By Nick Hut
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Health Plan Payment and Reimbursement
Leading provider associations have asked a federal court to halt the incorporation of criteria that appear to favor insurers over providers in an arbitration process to determine out-of-network payment amounts.
By Nick Hut
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Medicare Payment and Reimbursement
The House of Representatives is set to vote on a bill that would nullify a large share of 2022 Medicare payment cuts.
By Nick Hut
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Value-Based Payment
During a recent call with healthcare stakeholders, leaders with the Center for Medicare & Medicaid Innovation heard various ideas for improving value-based payment models.
By Nick Hut
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Coronavirus
A federal judge has halted implementation of a new rule that would require all on-site staff in hospitals and most other healthcare settings to be vaccinated against COVID-19.
By Nick Hut
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Coronavirus
If a hospital’s staff aren’t fully vaccinated by Jan. 4, the organization will be deemed noncompliant with Medicare and Medicaid regulations, according to a new federal rule.
By Nick Hut
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Leadership
HFMA’s new international Membership program reflects the Association’s mission to expand its support of healthcare finance professionals in the international community and to be a participant in the global agenda to improve health for all.
By Deborah Filipek
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Leadership
HFMA reached a significant milestone, surpassing 75,000 members in October, after 19 straight quarters of membership growth.
By Brad Dennison
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Cost Effectiveness of Health
Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: America’s most cost-effective hospitals are identified, employers have boosted telemedicine and mental health benefits during the pandemic, a...
By Deborah Filipek
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Medicare Payment and Reimbursement
Citing patient safety concerns among other issues, CMS formally canceled a Trump administration rule that would have required Medicare to cover breakthrough medical devices.
By Nick Hut
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Medicaid Payment and Reimbursement
In pending legislation, reductions to disproportionate share hospital payments would be used to subsidize commercial insurance for low-income residents of states that haven’t expanded Medicaid.
By Nick Hut
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Telemedicine
Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: A majority of people prefer in-person healthcare to telehealth visits, patients have trouble grasping information during doctor visits, and W...
By Deborah Filipek
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Financial Leadership
HFMA’s 2021 Annual Conference underscored a healthcare industry at a crossroads amid the lingering COVID-19 pandemic and daunting financial trends.
By Nick Hut
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Strategic Planning
At HFMA’s Annual Conference, David Shulkin, former secretary of the Department of Veterans Affairs, explained why some of the VA’s strategies would serve the healthcare industry well if implemented in the private sector.
By Nick Hut
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Coronavirus
The presentation of the Richard L. Clarke Board of Directors Award was meant as a salute to the immense sacrifice and overall contribution to healthcare of frontline workers during the pandemic.
By Nick Hut
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Finance and Business Strategy
Recognizing the strengths and weaknesses of healthcare’s culture is key to implementing needed industry changes, according to Robert Pearl, MD, former CEO of Permanente Medical Group.
By Paul Barr
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Financial Leadership
The pivot point marked by the COVID-19 pandemic is a chance for healthcare leaders to guide the industry in a direction that better serves all demographics, said HFMA National Chair Tammie Jackson.
By Nick Hut
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Medicare Payment and Reimbursement
CMS used the 2022 final rule for Medicare physician payments to offer accommodations on policies related to telehealth and more, but concerns loom about a large cut that's in the offing.
By Nick Hut
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Financial Leadership
The challenges facing the industry are momentous, but healthcare finance professionals should be optimistic about their ability to help find solutions, HFMA President and CEO Joe Fifer said during the kickoff session of the 2021 Annual Conf...
By Nick Hut
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Medicare Payment and Reimbursement
Medicare policies affecting price transparency, the inpatient-only list and more will take effect Jan. 1 after CMS published its 2022 final rule for hospital outpatient departments and ambulatory surgical centers.
By Nick Hut
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Coronavirus
If hospital staff aren’t fully vaccinated by Jan. 4, their organization will be deemed noncompliant with Medicare and Medicaid regulations, according to a new rule handed down Thursday by CMS.
By Nick Hut
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Quality Measures
Quality measures derived during the COVID-19 pandemic are not an accurate gauge of hospital performance in federal programs such as Value-Based Purchasing.
By Nick Hut
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Leadership
HFMA’s Oregon Chapter produces a regular podcast to keep healthcare finance professionals connected to the Chapter and informed of current healthcare industry issues.
By Crystal Milazzo
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Leadership
HRG has appointed HFMA members Mark Bell and Jason Coffin as CFO and COO, respectively. Five other HFMA members have been named as new CFOs for healthcare facilities around the country.
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Financial Leadership
Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Negative impacts of work spur nurses’ plans to leave their jobs, annual healthcare spending is higher than ever for insured individuals, and ...
By Deborah Filipek
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Wage Index
Wage index adjustments leave some hospitals at a disadvantage and are costly for the Medicare program, according to policy advisers.
By Nick Hut
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Cost Effectiveness of Health
In a recent study, a large group of patients with medically complex chronic conditions were referred to and seen at an Indianapolis-based outpatient critical care transition clinic saw fewer posthospital inpatient admissions and realized de...
By Deborah Filipek
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Payment Models
A forthcoming revamp of federal value-based payment models will include features designed to encourage provider participation, CMS and CMMI leaders said.
By Nick Hut
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Payment Trends
Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Insurers are behind in billions of dollars in payments to hospitals, the strain on clinicians and staff grows amid the pandemic, and CFO duti...
By Deborah Filipek
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Strategic Partnerships Mergers and Acquisitions
The number of M&A transactions involving hospitals and health systems remained at historically low levels, but the average revenue involved was far higher than in recent years.
By Nick Hut
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Staff Development
Learn more about HFMA’s Premium Facilitated Learning — a new line of courses — that combine self-directed study with expert facilitation in this Q&A with HFMA’s Sue Spear, director of Digital Learning and Todd Nelson, director of Partner R...
By Stephani Johnston
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Strategic Planning
A recent survey finds healthcare providers working to ensure their strategic planning incorporates key trends, spurring innovations in care delivery models.
By Nick Hut
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Patient Financial Communications
A newly issued federal rule on surprise billing includes regulations designed to improve price transparency for self-pay patients.
By Nick Hut
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Cost Effectiveness of Health
The head of the Center for Medicare & Medicaid Innovation spoke with an HFMA audience about the importance of efforts at the federal level and beyond to improve the cost effectiveness of health.
By Nick Hut
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Health Plan Payment and Reimbursement
A new rule establishes a process for resolving payment disputes between health plans and hospitals when regulations on surprise billing begin in 2022.
By Nick Hut
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Leadership
Danielle Gori, president of HFMA’s South Carolina Chapter, talks about how the diversity and inclusion initiative came about and the chapter’s plans for it.
By Crystal Milazzo
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Leadership
By Crystal Milazzo