Quality and Cost Reporting

Continued 340B eligibility is at risk for hundreds of hospitals thanks to pandemic-related factors

Hospitals that rely on savings from the 340B Drug Pricing Program should examine the possibility that they’ll soon be rendered ineligible. Several factors are having an industrywide impact on the disproportionate share hospital (DSH) adjustment percentage, and if that tally drops below a certain threshold on a hospital’s Medicare cost report, the hospital cannot receive…

Nick Hut February 2, 2024

Medicare’s hospital outpatient payment rate for 2024 improves marginally from the proposed rule

The final rule setting Medicare’s 2024 payment rates and policies for hospital outpatient services and ambulatory surgical centers (ASCs) contained no major surprises and little to make hospitals optimistic about the government portion of their payer mix. Here are five of the most important payment and coverage takeaways from the rule, which totals 1,672 pages…

Nick Hut November 7, 2023

Healthcare News of Note: What healthcare sector innovations are consumers most excited about?

Some 48% of healthcare consumers surveyed said improved insight into how much care would cost was the No. 1 item they were excited about when it came to innovation in healthcare. Employers can expect an increase of more than 20,000% in adolescent mental health telehealth costs, according to a study showing telehealth appointments cost an…

Deborah Filipek January 5, 2023

Clinical audits and denials impact 3% or more of NPR being held in reserve

This pulse survey shows how healthcare organizations are currently tracking health system’s audits and denials from government and commercial payers.

Jennifer Novoseletsky December 1, 2022

Clinical Audits and Denials Research Report

HFMA, with sponsorship by MRO, surveyed 317 healthcare revenue cycle, finance and accounting executives to understand how organizations are handling claim audits, risk exposure, claim tracking, and reserves.

HFMA November 10, 2022

Maximizing recoveries while ensuring patient satisfaction

As a provider, gain insight on how to look for a potential partner such as having ability to ensure patient satisfaction, understanding the revenue cycle and providing detailed reporting and analytics.

HFMA August 31, 2022

New rule sets forth proposed Medicare payment policies for rural emergency hospitals

For hospitals that choose to begin operating under the new rural emergency hospital designation in 2023, Medicare will pay for any service that would be covered as a hospital outpatient department service.

Nick Hut July 21, 2022

IPPS FY23 proposed rule: Tweaks are in store for Medicare’s quality-reporting and pay-for-performance programs

Temporary modifications to two pay-for-performance programs would ensure hospitals don’t face penalties amid the COVID-19 pandemic.

Nick Hut May 5, 2022

IPPS FY23 proposed rule: CMS seeks to bolster maternal health through a new public-facing hospital designation

Hospitals could attain the “Birthing Friendly” designation by attesting to having implemented best practices in maternal health.

Nick Hut April 26, 2022

CMS issues FY23 proposed payment rules for hospices, inpatient psychiatric facilities and inpatient rehabilitation facilities

CMS has released proposed FY23 rules governing prospective payments to hospices, inpatient psychiatric facilities and inpatient rehabilitation facilities.

Nick Hut April 8, 2022
googletag.cmd.push( function () { googletag.display( 'hfma-gpt-leaderboard' ); } );