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…
Honor Roll: HFMA certifications were awarded to 2,079 members January through March 2023
HFMA offers eight certifications for members to validate their expertise and demonstrate their commitment to the profession. The HFMA certifications are as follows: Certified Healthcare Financial Professional (CHFP), Certified Revenue Cycle Representative (CRCR), Certified Revenue Cycle Representative (CRCR) – GCC, Certified Specialist Accounting & Finance (CSAF), Certified Specialist Business Intelligence (CSBI), Certified Specialist Physician Practice…
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…
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…
Final rule for Affordable Care Act marketplace plans could expand contracting opportunities for certain types of providers in 2024
Final 2024 regulations for health plans participating in the Affordable Care Act (ACA) insurance marketplaces are designed to improve equitable access to behavioral healthcare, potentially meaning a wider array of providers will have a chance to be included in networks. As of 2023, a participating plan must have at least 35% of available essential community…
Healthcare disruptor Glen Tullman says providers need more of a consumer-centric approach
One of the country’s most prominent healthcare entrepreneurs has a warning for legacy healthcare stakeholders. “Many of you in the audience are leading major health systems, and you’re the hub for healthcare today,” Glen Tullman said during a presentation at the HIMSS Global Health Conference and Exhibition, which took place the week of April 17…
Hospitals are facing a long slog to return to pre-pandemic normalcy, panelists say
The logjam of patients who cannot be seen expeditiously at hospitals is becoming an entrenched problem with no imminent solutions, a CMS leader said this week. “The data tells us healthcare services, particularly for the Medicare population, have not come back to pre-pandemic levels,” said Jonathan Blum, principal deputy administrator and COO with CMS. “We’re…
State of Medicare: Some good news on program solvency still leaves questions and challenges
Medicare should remain solvent a little bit longer than previously anticipated, while a policy debate is ramping up over how to make the program sustainable for the long term. The 2023 annual report of the Medicare Boards of Trustees projects that the Hospital Insurance (HI) trust fund, which subsidizes Part A services, essentially will be…
Medicare’s proposed FY24 update to inpatient payments falls short, hospitals say
Hospitals are less than pleased with Medicare’s proposed FY24 payment update for inpatient care. In proposed regulations, 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 as a…