How the balance sheet can contribute to performance improvement
Significant opportunities for cost savings, enhanced liquidity and improved efficiencies lie within an organization’s debt structure, treasury operations and real estate portfolio. There has always been a connection between performance improvement initiatives and the balance sheet. By reducing operating costs, boosting productivity and enhancing revenues, a successful performance improvement initiative bolsters an organization’s financial performance.…
CMS issues RFI to gather best practices for identifying and supporting safety net hospitals
As part of the FY24 proposed rule for hospital inpatient payments, CMS is seeking healthcare stakeholder input on how to best support safety net hospitals in the Medicare program. The agency is considering ways to reimburse safety net hospitals via supplemental payments that may be better targeted than disproportionate share hospital (DSH) and uncompensated care…
Hospital price transparency updates include stricter enforcement, new fines and pending legislation
(Note: The last section of this article was updated May 24 where noted to reflect developments in Congress.) Enforcement of hospital price transparency regulations is becoming stricter, with CMS implementing new policies and recently fining two hospitals. Changes were anticipated after CMS leaders authored an article in February that reported 70% compliance in 2022, the…
Congress seems inclined to expand site-neutral payment policies in Medicare (updated)
Momentum is building in Congress toward expanding site-neutral payment in Medicare, a move that could reduce payments to hospitals by billions of dollars per year. A recent hearing, which lasted 5 ½ hours, focused on various ideas for promoting transparency and competition in healthcare. The hearing included references to 17 bills or discussion drafts, several…
The COVID-19 public health emergency is over: Here’s what healthcare providers should know
An era ends for the U.S. healthcare industry with the termination of the COVID-19 public health emergency (PHE) at the close of the day on Thursday, May 11. The termination means providers are losing many of the federal waivers and flexibilities that have been in place for all or most of the PHE, which took…
New data on No Surprises Act arbitration cases show providers are faring well amid systemic challenges
Providers are having success at challenging out-of-network payment amounts under the No Surprises Act, at least when they can get their cases through the arbitration system. CMS published an update showing that between April 15, 2022, when the independent dispute resolution (IDR) portal opened, and March 31, arbitrators issued payment determinations in 42,158 disputes. Initiating…
Are you ready for the Medicaid ‘unwinding?’
The phase-out, or “unwinding,” of the three-year Medicaid continuous enrollment program began on April 1, and states have started to disenroll ineligible members. They have 12 months to complete the recertification process. The HHS estimates that around 8.2 million Medicaid enrollees, of which 4.7 million are adults ages 18 to 34, will lose Medicaid coverage, while 5.3…
News Briefs: Medicare’s proposed FY24 update to inpatient payments falls short, hospitals say
Hospitals are less than pleased with Medicare’s proposed FY24 payment increase for inpatient care. In regulations released April 10, the net inpatient payment update is 2.8% after factoring in a mandatory productivity adjustment of -0.2 percentage points. As usual, the update would be reduced for any hospital that does not fulfill quality-reporting requirements or qualify…
5 issues that are keeping healthcare compliance professionals up at night
Rarely has the compliance landscape been more muddled or presented more of a challenge for healthcare organizations. “I’ve been a compliance officer for about 20 years now, and I’ve been in healthcare forever,” said Kirsten Wild, RN, a nurse by background who now owns a healthcare compliance consultancy. “But the volume and the pace of…
Kaiser Permanente is set to acquire Geisinger in a deal with major industry ramifications
In a move with implications for healthcare business models, Kaiser Permanente has announced plans to acquire Geisinger and form a new nonprofit organization. Upon acquisition Geisinger will join Risant Health, an organization that is being launched by Kaiser Permanente’s hospital arm. Geisinger and future acquisitions will operate as distinct entities and retain their current branding…