Hospital financial metrics suggest need for added Medicare payment, MedPAC says
Hospital metrics suggest FY26 Medicare payment should increase by more than what’s provided in the statutory formula, according to a formal recommendation by the Medicare Payment and Advisory Commission (MedPAC). Beneficiary access to care appeared to be strong in 2023, the latest year for which data was available, but quality indicators were mixed, according to…
Where value-based payment is headed during the second Trump administration
Like much of federal healthcare policy in the next few years, the push to improve value-based payment and accountable care figures to be influenced by two distinctive aspects of the Trump administration: MAHA and DOGE. MAHA is Make America Healthy Again, the movement championed by new HHS Secretary Robert F. Kennedy Jr., while DOGE is…
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.…