Summary: 10 vital responses to healthcare disruption
Note: This article is a summary of a report on HFMA’s Spring Thought Leadership Retreat. The full report is available to download. Disruption is reverberating throughout the healthcare industry, and it’s incumbent on legacy organizations to develop strategic responses for the benefit of their consumers, their communities and themselves. With that overarching challenge becoming ever…
News Briefs: Hospitals foresee adverse impacts from the FY24 inpatient payment rule
The FY24 final rule for Medicare inpatient payments didn’t bring hospitals the type of rate update they had sought, and for some organizations, a bigger concern is changes to uncompensated care (UC) payments. The regulations, which take effect Oct. 1, establish a 3.1% increase in operating payment rates, on average, for hospitals that meet quality-reporting…
Prices of drugs for diabetes, heart failure and more will be up for negotiation in Medicare next year
The U.S. Department of Health and Human Services (HHS) on Tuesday announced the first 10 Medicare Part D drugs that will be subject to price negotiations, the headlining healthcare-related provision of the Inflation Reduction Act. Signed in August 2022, the law gave Medicare authority to negotiate with drug manufacturers over the prices of selected drugs.…
8 Chapters receive 2023 HFMA Success Awards
Each year, leaders of HFMA’s chapters and regions gather at the Leadership Training Conference to plan for the year ahead and to acquire the skills and resources needed to go back home and make it happen. This year’s event took place April 16-18 in San Antonio, Texas. One of the highlights was the volunteer recognition…
Ken Perez: How homelessness and healthcare are inextricably linked
Homelessness is a worsening problem for the United States, and in multiple ways, it is a healthcare issue. Many of our nation’s failed efforts to solve this problem, outlined below, do not fully acknowledge this reality. But a promising new not-for-profit initiative, Built for Zero, may provide a truly viable solution using a data-driven approach…
No Surprises Act litigation update: QPA methodology deemed illegal as Texas Medical Association wins in court again (updated)
Note: The first section of this article has been updated with the latest news on the status of the arbitration portal. The fourth victory in four cases brought by the Texas Medical Association (TMA) has implications for how insurers calculate the qualifying payment amount (QPA) used to arbitrate out-of-network payment sums under the No Surprises…
What to expect when a consultant call-in report is required
Amid today’s difficult operating environment, some organizations face the prospect of breaching covenants in their master trust indenture (MTI) or bank loan documents, particularly covenant requirements for debt service coverage or days cash on hand. In the event of a breach, management is typically required to hire an independent consultant to identify areas for financial…
Data indicate hospital operational logjams haven’t ceased after the public health emergency (updated)
Note: The fourth section of this article has been updated with news of proposed mandatory staffing ratios for long-term care facilities. Some of the problems that strained hospital operations during the peak of the COVID-19 pandemic have eased, but not enough to mark a true industrywide recovery, a recently released report suggests. Notably, the process…
Children’s hospitals swim against the tide to improve the health of their patients and communities
As the nation’s pediatric hospitals strive to keep kids healthy, they face obstacles that reflect the difficulty of enacting structural changes in care delivery. Even pediatric hospitals that are eager to engage in value-based payment (VBP) models can have a hard time establishing the type of network that allows them to affect the holistic health…
Regulators seek feedback about medical credit cards as potential restrictions loom
A federal request for information signals heightened scrutiny on the issuance of credit cards in healthcare settings. The Consumer Financial Protection Bureau, Department of Health and Human Services and Department of the Treasury sent out an RFI in July to gain stakeholder feedback on whether the widespread availability of medical payment products such as credit…