Addressing social determinants of health in revenue cycle management
Integrating SDoH into RCM provides equitable care and improves financial outcomes. By addressing economic and social barriers early in the RCM process, providers enhance patient experiences and reduce costs. This approach aligns with value-based care models and improves overall health outcomes.
Various 340B issues mean potential headaches for providers in 2025
The 340B Drug Pricing Program, a key source of cost savings for participating hospitals, faces intensifying pressure in the early part of the new year. Drug companies are pursuing efforts to limit the ability of hospitals to realize their full allotment of savings, while Congress eyes the program as a possible way to trim federal…
Hospital financials projected to continue trending upward despite various X-factors
Hospitals are coming off a year of improved stability that should continue even with looming questions and challenges for 2025, according to recent data and insights. As reported in December, Fitch Ratings upgraded the sector outlook (login required) for not-for-profit (NFP) hospitals to neutral/stable after more than two years in which the outlook was categorized…
Benchmark tool for revenue cycle automation finds some success
A just over one-year-old revenue cycle management benchmarking tool has been working well for two early adopters of the framework, called the Revenue Cycle Management Technology Adoption Model (RCMTAM). The Pennsylvania Mountains Healthcare Alliance (PMHA) and UC San Diego Health (UCSD) have used the model to gain more clarity on how their RCM operations are…
Texas Health Resources enhances self-scheduling with flexible options
Amid expected growth in demand from patients to schedule their own clinic visits, an Arlington, Texas-based health system learned that in practice some patients want more than just the ability to go online to choose a visit time, date and provider. Officials for Texas Health Resources (THR) found that out while implementing a new self-scheduling…
How regulatory shifts are shaping the future of revenue cycle operations
The healthcare industry is set for a major transformation, driven by government policies, legislative reforms, insurance updates and a continuous evolution of compliance and privacy standards that impact revenue cycle management (RCM). These developments present both challenges and opportunities for RCM teams but embracing them is crucial for healthcare organizations to thrive. Key regulatory changes…
Amid tight margins, MedPAC seems set to recommend an additional hospital payment boost
Hospitals have improved financially in the latest reporting period but still should receive a supplementary Medicare payment increase, according to a meeting of the Medicare Payment Advisory Commission (MedPAC). For 2026, Congress should authorize a 1% increase beyond the amount calculated using the statutory methodology, commissioners said during a December discussion. The notion is likely…
As data show a spike in spending on hospital services, new report lays out savings options
Accelerating hospital-focused expenditures helped spur a 2023 increase in national health spending, according to newly released data. Spending on hospital services surged by 10.4% for the year, up from a 3.2% increase in 2022 and 3.4% for the three-year period spanning 2020-22. The 2023 increase was the biggest seen since a 10.8% jump in 1990.…
9 features of a revitalized healthcare workforce
As the 2030s approach, the horizon looks daunting for the healthcare workforce. Consider these trends: The entire baby boomer generation will be eligible for Medicare coverage by the turn of the decade. Clinician shortages are projected to be well into the six figures by 2034, accelerated by a reported exodus of 145,000 clinicians in 2021…
As transparency rules enter their fifth year, advanced uses gain traction
With price transparency rules becoming more entrenched in the healthcare system, applications are growing more sophisticated. “There’s this treasure trove of data out there, and a lot of interest in how it can best be leveraged to support not just consumers but also broader policy goals to improve healthcare affordability,” Sabrina Corlette, JD, co-director of…