Congress seems inclined to expand site-neutral payment policies in Medicare (updated)
Momentum is building in Congress toward expanding site-neutral payment in Medicare, a move that could reduce payments to hospitals by billions of dollars per year. A recent hearing, which lasted 5 ½ hours, focused on various ideas for promoting transparency and competition in healthcare. The hearing included references to 17 bills or discussion drafts, several…
New data on No Surprises Act arbitration cases show providers are faring well amid systemic challenges
Providers are having success at challenging out-of-network payment amounts under the No Surprises Act, at least when they can get their cases through the arbitration system. CMS published an update showing that between April 15, 2022, when the independent dispute resolution (IDR) portal opened, and March 31, arbitrators issued payment determinations in 42,158 disputes. Initiating…
Honor Roll: HFMA certifications were awarded to 2,079 members January through March 2023
HFMA offers eight certifications for members to validate their expertise and demonstrate their commitment to the profession. The HFMA certifications are as follows: Certified Healthcare Financial Professional (CHFP), Certified Revenue Cycle Representative (CRCR), Certified Revenue Cycle Representative (CRCR) – GCC, Certified Specialist Accounting & Finance (CSAF), Certified Specialist Business Intelligence (CSBI), Certified Specialist Physician Practice…
5 issues that are keeping healthcare compliance professionals up at night
Rarely has the compliance landscape been more muddled or presented more of a challenge for healthcare organizations. “I’ve been a compliance officer for about 20 years now, and I’ve been in healthcare forever,” said Kirsten Wild, RN, a nurse by background who now owns a healthcare compliance consultancy. “But the volume and the pace of…
Enterprisewide physician advisor programs are key to improving costs and revenue cycle performance
Making sure physicians understand the financial implications of how they document their care is critical to a health system’s financial sustainability.
Healthcare disruptor Glen Tullman says providers need more of a consumer-centric approach
One of the country’s most prominent healthcare entrepreneurs has a warning for legacy healthcare stakeholders. “Many of you in the audience are leading major health systems, and you’re the hub for healthcare today,” Glen Tullman said during a presentation at the HIMSS Global Health Conference and Exhibition, which took place the week of April 17…
Assessing Reality in Healthcare Financial Information
Healthcare stakeholders, including management, regulators, investors, rating agencies, lenders, media and others seek information to evaluate operating margins and profitability metrics for hospitals and other healthcare organizations. Financial statements, tax/information returns and Medicare cost reports are key information sources for the healthcare industry, but many times they convey seemingly contradictory information, which creates confusion for…
Medicare’s proposed FY24 update to inpatient payments falls short, hospitals say
Hospitals are less than pleased with Medicare’s proposed FY24 payment update for inpatient care. In proposed regulations, the net inpatient payment update is 2.8% after factoring in a mandatory productivity adjustment of -0.2 percentage points. As usual, the update would be reduced for any hospital that does not fulfill quality-reporting requirements or qualify as a…
Robert Turner: Avoiding a bond covenant default takes aggressive action from a health system borrower
Not-for-profit hospitals and health systems have faced an increasingly difficult operating environment since inflation began to grow in mid-2021. Last year was particularly hard, beginning with a new wave of COVID-19 infections caused by the omicron variant, and followed by mounting expenses, staffing shortages, rising interest rates and investment losses. As a result, Kaufman Hall…
Creating sound strategies to manage compensation and benefits regardless of where your employees reside
No doubt there are significant cultural and financial benefits to supporting continued remote and hybrid work in healthcare, particularly in billing/coding, call center, scheduling and administrative roles. Healthcare, however, faces specific challenges as they seek to demystify multi-state tax rules.