How to make direct contracting finances work
As direct contracting arrangements grow — including one state requiring health systems to offer them — a leading provider identified keys to boosting their finances. Nick Stefanizzi, CEO of Northwell Direct, leads Northwell Health’s for-profit direct contracting subsidiary. Since adding its first customer in 2022, it has grown to serve more than 300,000 employee members…
Site-neutral payment changes are most likely congressional reform this year
Legislation pushing site-neutral payments remains the most likely healthcare policy change to pass Congress this year, as it enters the final months of the legislative calendar. Congress is about to depart for its annual August recess, which will leave only a month and a half on the legislative calendar for action before the midterm elections.…
Biggest SDP recipients raise concerns about implementing rule
Hospitals in the states that receive the most funding from state-directed payments (SDPs) identified the range of impacts from a proposed rule and suggested alternative approaches. The comments from hospitals and hospital advocacy groups came in response to a proposed rule implementing SDP provisions of the One Big Beautiful Bill Act (OBBBA). OBBBA, enacted a…
What appeals court 340B rebate decision means for federal rebates
An appeals court barred 340B rebate programs by drug manufacturers, among recent legal developments. The case could have ramifications for federal 340B rebates. On July 21, the U.S. Court of Appeals for the D.C. Circuit upheld a lower court ruling that barred alternative 340B rebate models without explicit approval from HHS. “That’s certainly welcome news…
Medicaid programs mull dropping insurers
Various state Medicaid programs are considering replacing outside managed care plans with in-house management. Such a reversal of the multi-decade trend to outsourcing overall management of Medicaid plans to various insurers and reverting to fee-for-service (FFS) Medicaid could have major ramifications for hospitals and health systems. Bruce Greenstein, secretary of the Louisiana Department of Health…
Vizient: Healthcare utilization shifts will reshape care delivery over the next decade
A slowdown in inpatient admissions was among the 10-year health system volume projections in the annual look ahead from Vizient. The 2026 Impact of Change forecast, released June 30, highlights how shifts in care delivery, patient complexity and site-of-care access challenges are reshaping healthcare utilization and will change the structure of the healthcare continuum. Here…
How Congress sees direct contracting impacting hospitals
Members of Congress said they expect hospitals and health systems to see both financial benefits and losses under a broader rollout of direct contracting. An expansion of direct contracting and direct primary care (DPC) between employers and providers drew bipartisan support at a July 1 congressional hearing that highlighted legislation to boost such arrangements. These…
FastFinance: AI nurse opposition; OPPS changes detailed
HFMA’s FastFinance newsletter is now a podcast. Host Rich Daly discusses the most current and relevant healthcare news, delivered in an easily digestible format. AI resistance by nurses is spreading nationwide but there are ways hospitals can use it to boost their productivity while minimizing opposition. Also, this week’s Weird Number: 66%. That’s the share…
Hospitals confront nursing opposition to AI
Health systems’ adoption of artificial intelligence to improve productivity increasingly is meeting opposition from their nursing staff. Nurse opposition to AI has become most visible in nurse strikes, where limits and guardrails on AI deployment for clinical and administrative uses have emerged. Sixty-five percent of hospitals reported using AI or predictive models integrated with their…
States push new hospital funding arrangements
States are implementing a growing number of initiatives to provide funding for rural or otherwise financially struggling hospitals. This push comes amid data showing that a record number of hospitals are financially distressed, and advocates warn that coming federal Medicaid cuts will worsen the situation. Indiana targeted funds Indiana hospitals celebrated a new arrangement within…