Hospital finances are on the upswing, but the toll of the Change Healthcare outage is yet to be seen
There is reason to be optimistic about the state of hospital finances, but the impact of the Change Healthcare cyberattack has added uncertainty to the forecasts. Financial metrics for the first two months of 2024 continued to show a steady recovery from pandemic-era doldrums, especially those that were seen in 2022 and part of 2023.…
Health systems start to fight back against AI-powered robots driving denial rates higher
Two fighters face each other in the ring, circling together, assuming there will be a single victor. One, representing the U.S. health insurance industry, has made huge investments in aggressive technology over the past several years to automate claim processing and reviews, making it hard for the other fighter — representing the nation’s healthcare providers…
The FY24 HHS budget covers key programs for rural hospitals while tightening spending in some areas
The newly passed budget covering HHS during the remainder of FY24 contains notable provisions for healthcare providers. The roughly $117 billion departmental budget for the next six months was set in an appropriations bill that was passed by Congress and signed by President Joe Biden within hours of the March 22 expiration of funding for…
Hospitals warrant an extra boost in their Medicare payment rate next year, MedPAC says
Hospitals will get a more favorable Medicare payment increase in FY25 if Congress follows the recommendations of the Medicare Payment Advisory Commission (MedPAC). In its semiannual report to Congress, MedPAC recommended a 1.5% bump on top of what otherwise would be provided according to statute. That would mean an estimated increase of about 4.5% for…
Cyberattack on Change Healthcare brings turmoil to healthcare operations nationwide
Editor’s note: If you are an HFMA member from a provider organization, consider submitting a request to join the Change Healthcare Business Continuity Workgroup (https://community.hfma.org/change-healthcare-workgroup/). Information about future calls, mitigation strategies and industry updates will be shared in this group. HFMA welcomes participants to use the discussion forum to address challenges and explore solutions with…
The federal policy response to the Change Healthcare cyberattack
Note: This information is excerpted from HFMA’s running coverage of the cyberattack that disabled operations at Change Healthcare. On March 10, HHS and the Department of Labor sent a letter encouraging commercial payers to do their part to help financially strained providers nearly three weeks after the cyberattack on Change Healthcare. “Larger payers in particular…
Responses to a new RFI will help guide regulations addressing consolidation and private equity in healthcare
The Biden administration is ramping up its assessment of how to regulate consolidation and private equity (PE) acquisitions in healthcare, issuing a request for information (RFI) from stakeholders. There is a deadline of May 6 to submit comments on the RFI, which was distributed by HHS, the Department of Justice (DOJ) and the Federal Trade…
Federal funding legislation would address Medicaid DSH cuts, physician payments and more
March 8 update The Senate passed the appropriations bill by a 75-22 vote, getting it to the White House for President Joe Biden to sign hours before funding for some federal departments would have expired and a big cut to Medicaid disproportionate share hospital payments would have begun. Attention now turns to HHS and other…
New rule on Medicaid DSH payments will impose stricter limits on many hospitals
Numerous hospitals that receive Medicaid disproportionate share hospital (DSH) payments face a tighter cap on their payment amounts after the Feb. 23 publication of a CMS final rule. The regulations were spawned by 2020 year-end legislation that made changes to the DSH hospital-specific limit (HSL), including with respect to how third-party payments factor into the…
New data shows providers continuing to win most No Surprises Act independent dispute resolution cases
Providers won a large majority of disputes initiated during the first half of 2023 through the No Surprises Act’s arbitration portal for adjudicating out-of-network payments, according to newly published data. HHS and the U.S. Departments of Labor and Treasury released public-use files (available to download here under “2023 Reporting Year”) showing the outcome of every…