News

Key Senate committee takes a close look at healthcare waste and prices

The U.S. Senate is intent on finding ways to improve the value of healthcare, according to takeaways from a recent hearing of the Budget Committee. Although other committees and subcommittees in both chambers of Congress have held meaningful hearings about healthcare policy and costs this year, the Budget Committee’s attention to the matter is especially…

Nick Hut December 7, 2023

Pharmacy transparency: a rising trend in the industry

After publishing my Nov. 29 blog, which delved into Cost Plus Drugs’ expansion into the specialty drug market, CVS Health revealed plans to streamline its pricing and sales approach for pharmaceuticals in retail pharmacies. This move by the pharmacy giant, which operates approximately 9,500 retail pharmacies, involves simplifying the reimbursement process for these pharmacies. The…

Shawn Stack December 7, 2023

Prior authorization in Medicare Advantage remains in the policy spotlight as 2024 regulations take effect

Healthcare policymakers and stakeholders continue to mull the need for guardrails to ensure optimal customer service among Medicare Advantage (MA) health plans. The American Hospital Association wrote a Nov. 20 letter to CMS stating that MA plans are looking to skirt policies designed to ensure straightforward coverage of essential healthcare services. These policies, finalized earlier…

Nick Hut December 1, 2023

Healthcare News of Note: 45% of consumers have at least 1 health-related social need

Over the past few weeks, I have found these recent industry news stories that should be of interest to healthcare finance professionals. 1. 45% of consumers surveyed have at least 1 health-related social need, says McKinsey & Company Forty-five percent of consumers report experiencing at least one health-related social need (HRSN), such as food insecurity,…

Deborah Filipek November 30, 2023

Cost Plus Drugs announces its expansion into specialty drugs

If you have ever attended one of my lectures over the past three years, it is very rare that I don’t at least mention Cost Plus Drugs and the impact they have made in the pharmaceutical sales industry. The latest news on Cost Plus Drug Company Just this week, Mark Cuban, the founder of Cost…

Shawn Stack November 29, 2023

Congress doesn’t seem to be mulling a fix for the 2024 Medicare physician payment cut

Congress has mitigated a scheduled Medicare payment cut for physicians going into each of the last three years, but relief does not appear to be on the way for a fourth year running. Medicare’s 2024 final rule for physician payments includes a $1.15 decrease to the conversion factor, amounting to a reduction of more than…

Nick Hut November 27, 2023

Proposed rule sets Medicare penalties for providers that commit information-blocking infractions

Hospitals and other healthcare providers would face penalties for knowingly engaging in information blocking, with the sanctions affecting their Medicare reimbursement, according to a proposed rule from the U.S. Department of Health and Human Services (HHS) and CMS. Published at the beginning of November, the rule implements some terms of the 21st Century Cures Act,…

Nick Hut November 17, 2023

Healthcare News of Note: The Leapfrog Hospital Safety Grade shows hospitals ‘significantly’ reduced 3 hospital-acquired infections post-pandemic

Over the past few weeks, I have found these recent industry news stories that should be of interest to healthcare finance professionals.   1.  Healthcare-acquired infection scores improve for hospitals, but patient experience scores continue to decline, says new Leapfrog report Although hospitals are doing better when it comes to reducing healthcare-acquired infections (HAIs) “after significant…

Deborah Filipek November 16, 2023

Senate bill would give hospitals a big break from looming Medicaid disproportionate share hospital cuts (updated)

Nov. 15 update: On Nov. 14, the House passed legislation on a bipartisan basis to keep the government funded through Jan. 19. Medicaid disproportionate share hospital payments would be guaranteed to remain at their full amount through that date, and the bill similarly maintains short-term funding for graduate medical education, community health centers and the…

Nick Hut November 13, 2023

CMS finalizes enhanced hospital price transparency requirements for 2024

Hospital price transparency mandates are set to become more stringent in the coming year as CMS seeks to strengthen regulations that have been on the books since 2021. Medicare’s 2024 final rule for hospital outpatient payments includes updates to the price transparency rules. Hospitals will need to post charge information using a more precise template,…

Nick Hut November 9, 2023
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