Healthcare News of Note: Medicare to negotiate reduced prices for 40 drugs by 2028, says study
Medicare drug price negotiation has the potential to benefit Medicare beneficiaries across some of the most common disease states.
Data capture and coding for social determinants of health are works in progress, per reports
In the effort to bring social determinants of health (SDoH) more under the purview of healthcare providers, one tricky aspect is establishing a data and coding infrastructure. Recent reports highlight this challenge. For example, a survey conducted for the American Health Information Management Association (AHIMA) found that although 78% of 2,637 respondents said their organizations…
Healthcare News of Note: New PCORI initiative targets industry’s slowness in adopting results of comparative effectiveness research
Over the past few weeks, I have found these industry news stories that should be of interest to healthcare finance professionals. 1. Goal of PCORI initiative: Reduce the estimated 17-year wait time to adopt new and better treatments Forty-two health systems have signed on to an initiative to translate new research into changes in…
How R1 RCM’s technology-driven solutions address health system challenges
Seeing challenges in labor shortages, shrinking margins and other complexities? Enter technology-driven solutions for revenue cycle management. Read the details in this peer review spotlight.
AI and the rise of human-machine collaboration in healthcare
Commentators, researchers and academics can’t stop finding applications for ChatGPT.a Two of its recent claims to fame include passing all three medical licensing exams and the final exam for a core MBA class at Wharton.b ChatGPT, short for Chat Generative Pre-Trained Transformer, is a form of conversational artificial intelligence (AI). The concept is not new.…
DOJ withdraws guidance that bolstered antitrust safe harbors for GPOs, cost benchmarking and more
Potentially leading to stricter enforcement of antitrust policy in healthcare, the U.S. Department of Justice has withdrawn guidance that essentially promoted certain arrangements in the industry. The Feb. 3 announcement from DOJ’s Antitrust Division amounts to a cancellation of so-called “safety zones” that were established in three sets of nonbinding guidance issued between 1993 and…
How to use analytics and automation to build an intelligent A/R strategy
Health systems seeking to improve their accounts receivable function are turning to machine learning and AI to streamline patient interactions in ways that benefit the organizations and their patients. Read the challenges and benefits of using automation health system executives discuss in this roundtable.
Beyond automation: Fulfilling your New Year’s resolution for a more efficient revenue cycle
Jonathan Wiik, vice president of health insights at FinThrive, discusses how provider organizations continue to struggle with denials in a time when staff is hard to find.
Massive federal spending bill alleviates reimbursement concerns for hospitals, but less so for physicians
Healthcare provider advocates applauded the inclusion of key reimbursement relief measures and other policies in a proposed federal spending bill for FY23, although physician groups expressed concern about the outlook for their constituents. With a divided Congress looking to muster the votes to pass the legislation before a self-imposed deadline of week’s end, the bill includes many…
Prior Authorization and Interoperability for Medicare Advantage, Medicaid, CHIP, and QHPs Proposed Rule Summary
HFMA presents a detailed summary of the proposed rule designed to improve the electronic exchange of health care data and streamline prior authorization processes, while continuing to encourage interoperability in the healthcare market.