Payment approaches to addressing health equity are seen in a new Medicare rule for kidney care
Updates to a Center for Medicare & Medicaid Innovation care model for end-stage renal disease include an equity-related bonus payment and associated changes to benchmarking.
Hospitals and Congress propose improvements to prior authorization processes in Medicare Advantage
The American Hospital Association says pending regulations that would affect prior authorization should be expanded to include Medicare Advantage.
Hospital groups express concern over earlier court ruling that could expand False Claims Act liability
The groups argue that allowing FCA claims to be brought for post-termination actions would defy congressional intent and leave hospitals subject to excessive financial liability.
Healthcare News of Note: Average billed charge for complex COVID-19 hospitalizations is more than three times the allowed amount
Report by Medicare trustees describes a daunting payment picture for healthcare providers
The Medicare Hospital Insurance Trust Fund is on course to run out of money by 2026, and that assessment wasn’t the only concerning part for hospitals in a new government report.
HHS can continue using Worksheet S-10 to calculate uncompensated care payments after federal court ruling
A federal district court dealt hospitals a defeat in a case about uncompensated care payments, issuing a summary judgment in favor of the U.S. Department of Health and Human Services.
4 keys to sustaining financial viability in the shift to value
A leading ACO in Texas has found a way to thrive despite systemic factors that can discourage value-based initiatives.
OIG report suggests Medicare pays too much to cover capital costs for new hospitals
A new federal report indicates CMS pays excessively to cover capital expenditures during the first two years of a hospital’s existence.
How physicians, hospitals and health systems should prepare for the operational and financial impact of 2021 E/M code changes
In this Q&A, Craig Joseph, MD, chief medical officer for Nordic Consulting Partners, provides insight into why physicians, hospitals and health systems should pay attention to new E/M coding guideline changes are going into effect on January 1, 2021.
Research examines whether financial challenges facing hospitals with large Medicare populations lead indirectly to cost shifting
Harvard researchers found evidence to suggest that hospitals with large shares of Medicare patients are at greater risk of being acquired, which can skew the market structure and lead to higher commercial prices.