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340B providers are at a disadvantage after the latest court ruling on contract pharmacies

A decision issued by an appeals court represents the latest setback for 340B providers hoping to secure widespread access to price discounts on Medicare Part B drugs. The U.S. Court of Appeals for the District of Columbia Circuit on May 21 upheld a district-court ruling that drug manufacturers can impose restrictions on the 340B discounts…

Nick Hut May 24, 2024

Hospital payments have been substantially affected by the Change Healthcare cyberattack, report finds

Newly published data reflect the extent of the payment loss experienced by hospitals and health systems during the first month or so after the Change Healthcare cyberattack. A report (registration required) published in mid-May by Strata finds that gaps in expected revenue ranged from 16.5% to 17.9% per hospital for Q1. The insights were culled…

Nick Hut May 20, 2024

HHS issues regulations to strengthen anti-discriminatory protections in healthcare

Healthcare providers should be aware of the compliance requirements in sweeping new federal regulations intended to improve health equity and reduce healthcare disparities. An HHS final rule expands upon Affordable Care Act (ACA) Section 1557 language that has prohibited discrimination on the basis of characteristics such as race, color, national origin (including English proficiency), age,…

Nick Hut May 14, 2024

Ascension systems remain down after cyberattack

Executives with Ascension health system, St. Louis, are keeping in contact with leading law enforcement agencies and industry organizations as they work to restore systems that were shuttered by a cyberattack. The apparent ransomware attack has led to a shutdown of different systems that will last for an undetermined period of time. The attack also…

Paul Barr, MS, MBA May 13, 2024

Bridging the gap: Integrating value-based care into revenue cycle management

The idea of value-based care (VBC) has existed for decades but only gained momentum since the 2017 implementation of the Merit-based Incentive Payment System (MIPS) and the Quality Payment Program (QPP). VBC incentivizes providers for quality outcomes, unlike fee-for-service models that reimburse providers for each service performed. The ultimate goal of VBC is to improve…

HFMA May 10, 2024

Annual report on Medicare financing could reduce the immediate impetus to address longstanding issues

New data on the state of Medicare funding show short-term improvement while keeping the stakes high for ensuing decades. The annual report from Medicare’s trustees shows the Hospital Insurance Trust Fund (i.e., Medicare Part A) has enough money to keep beneficiaries covered and providers paid through 2036. That’s an increase of five years from the…

Nick Hut May 9, 2024

Closures of Walmart’s health centers reflect the widespread financial constraints in U.S. healthcare

Beyond signaling a setback for retail-based healthcare disruptors, Walmart’s recent decision to close its health centers is symptomatic of issues hampering the nation’s ecosystem for primary care, industry analysts say. The retail behemoth announced April 30 it would be closing all 51 of its health centers across five states, along with its virtual-health service. Five…

Nick Hut May 7, 2024

Congressional hearings on the Change Healthcare cyberattack bring attention to providers’ continuing predicament

Two congressional hearings involving the CEO of UnitedHealth Group offered few concrete solutions to the issues surrounding the Change Healthcare cyberattack but did highlight the ongoing pressures facing healthcare stakeholders. Andrew Witty, the CEO, was questioned May 1 by the Senate Finance Committee in the morning and a House subcommittee in the afternoon. For providers…

Nick Hut May 2, 2024

Demonstrating revenue cycle excellence just got easier with the newest HFMA certification

The Executive of Healthcare Revenue Cycle (EHRC) certification, HFMA’s newest member recognition, has been quite popular with members since it was announced in mid-February. As of March 31, 22 HFMA members had applied for the EHRC certification and 18 members earned it, demonstrating excellence in revenue cycle, said Shirley Heavlin, certification operations manager for HFMA.…

Deborah Filipek May 2, 2024

Seeking to improve healthcare for Medicaid beneficiaries, CMS issues a flurry of regulations

CMS over the last month published a trio of final rules intended to make the Medicaid program work better for beneficiaries, with implications for healthcare providers. The three rules address eligibility and enrollment, access and Medicaid managed care. Streamlining eligibility and enrollment The first rule addresses administrative barriers in an effort to simplify enrollment processes…

Nick Hut May 1, 2024
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