Cost Effectiveness of Health

Medicare’s proposed outpatient payment update for 2025 doesn’t keep pace with hospital costs, advocates say

Note: Additional coverage of the proposed rule can be found here. Hospital advocates expressed dissatisfaction with the payment update in Medicare’s 2025 proposed rule for hospital outpatient care and ambulatory surgical centers (ASCs). CMS proposes to increase the Medicare rate for outpatient services and ASCs by 2.6%, resulting from a 3% jump in the market…

Nick Hut July 11, 2024

Healthcare providers face Medicare payment-rate penalties for information blocking under new rule

Healthcare providers will receive a lower Medicare payment update if they are deemed to have engaged in information blocking, according to a final rule from HHS and CMS. For hospitals, a violation will leave the organization noncompliant with the Promoting Interoperability Program, meaning it would lose out on three-quarters of the annual market-basket update for…

Nick Hut July 3, 2024

Annual Conference Day 1: HFMA, AHA leaders hold forth on the state of the healthcare industry

HFMA’s 2024 Annual Conference began Monday afternoon with HFMA’s Ann Jordan and the American Hospital Association’s Rick Pollack rallying attendees to address the profound challenges and opportunities facing the industry. To start, Jordan, HFMA’s president and CEO, highlighted the conference theme, “A New Frontier in Health.” Frontier is “an exciting and unsettling word that really…

Nick Hut June 25, 2024

Saying goodbye to the BMI

In this episode, Dr. Holly Ann Russell, an associate professor of family medicine at the University of Rochester Medical Center and medical director for the Center of Community Health and Prevention, discusses why providers should stop using the Body Mass Index as a health measure and why weighing patients at every visit is unnecessary.

Erika Grotto June 17, 2024

Hospitals can bring their case on disproportionate share hospital payments to the Supreme Court

The Supreme Court granted hospitals’ request that it hear their appeal about the formula for determining Medicare disproportionate share hospital (DSH) payments, landing the case on the docket for the 2024-25 term. More than 200 hospitals are plaintiffs in the case. A federal district court ruled for HHS and against the hospitals in 2022, and…

Nick Hut June 12, 2024

Ken Perez: How 3 presidential candidates are defining their prescription drug pricing policies

What do voters care most about? It’s arguably the most salient question in every election cycle. Each March, to answer that question, Gallup asks Americans to rate their concern about a variety of national issues. This year’s survey asked respondents about 14 different issues.a Inflation came out on top, with 55% of those surveyed worrying…

Ken Perez June 2, 2024

Maryland’s example is no solution to healthcare’s true crises

In the wake of Medicare’s enactment in 1965, healthcare costs in the United States began rising at double-digit rates annually.a Many policy experts blamed hospital costs, which by 1980 had reached almost 41% of health spending.b It was believed that if you contained hospital costs, overall health spending would come under control. In 1974, the…

Jeff Goldsmith, PhD May 22, 2024

Optimizing 340B participation compliantly while “waiting and watching” new developments

Since 1992, the 340B program has required drug manufacturers to provide eligible healthcare organizations and other covered entities with drugs to be used for these organizations’ outpatients at significantly reduced prices, with the intent of helping safety net organizations improve their financial stability. In turn, hospitals are expected to demonstrate that the savings they receive…

Lauren Gorski May 22, 2024

Hospital payments have been substantially affected by the Change Healthcare cyberattack, report finds

Newly published data reflect the extent of the payment loss experienced by hospitals and health systems during the first month or so after the Change Healthcare cyberattack. A report (registration required) published in mid-May by Strata finds that gaps in expected revenue ranged from 16.5% to 17.9% per hospital for Q1. The insights were culled…

Nick Hut May 20, 2024

The power of AI in healthcare: a leader’s guide

In this new guide, explore five key areas every healthcare organization should consider when developing a generative AI strategy and assessing potential vendors’ solutions.

HFMA May 6, 2024
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