What the Trump administration told finance leaders
Several high-level healthcare officials from the Trump administration, including the CMS administrator, addressed various components of health policy at the HFMA Annual Conference last week. Their comments provided some insights on how the administration thinks about policy, industry trends and innovations. ‘Definitely not terminal’ Mehmet Oz, MD, administrator of CMS, said the “breakthrough ideas” of…
Health systems approach risk with payers
Health systems are finding different interest and approaches to downside risk in value-based care (VBC) among health plans in their markets. Mark Bortnem, CFO of Essentia Health, said some of their payers have clinical teams that will partner with Essentia’s medical leadership to strategize collectively about how to reduce low-value care and avoidable care. However,…
FastFinance: Provider plan challenges; Digital diversion tool
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. Hospitals and health systems have launched an increasing number of health plans in recent years and now provider plan challenges mean they need major re-assessments and decisive action. Also, this week’s…
Not dead: Provider-sponsored plans reassessing
Provider-sponsored health plans (PSHPs) proliferated in recent years and now face a historically challenging market. Some are reassessing, while others are in wait-and-see mode, says an adviser. From 2018 through 2023 the number of hospitals owning PSHPs increased from 692 (18.3% of hospitals) to 834 (27.2%), according to a new study published in JAMA by…
Amid ED surge, hospitals add diversion tools
Surging emergency department (ED) volumes have led a growing number of health systems to launch digital tools to divert nonemergent patients to alternative sites of care. Hospital ED volumes have increased 25% since 2021, according to the medians [subscription required] of rated hospitals tracked by Moody’s Investors Service. High ED volumes have resulted in overcrowding…
Policy clarity drives hospitals’ M&A surge
Hospital mergers and acquisitions (M&As) jumped in 2026 to a six-year high amid greater clarity in policies that will affect those organizations. Hospital M&A activity comes in stark contrast to other parts of the healthcare sector, which have slowed transactions due to higher borrowing costs. The 22 hospital and health system transactions announced in Q1…
Providers not seeing prior authorization improvement
Amid promises from health plans that they have dialed back their use of prior authorization, hospitals and health systems are not seeing any reduction in their use, say advisers. In April, health plans announced that they eliminated 11% of prior authorizations (PAs) across a range of medical services, representing 6.5 million fewer PAs for patients.…
FastFinance: Patient collections trends; SDP cuts rule
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. Hospitals and health systems have improved their front-end patient collections over the last year. But back-end collections are faltering. Also, this week’s Weird Number: $1.3 billion. That’s the amount of Medicaid…
15 trends from UnitedHealthcare
A surge in high-cost claims was among the trends last year that UnitedHealthcare identified in its employer-sponsored health plans. The dominant healthcare payer’s 2026 Health Trends Report used data from UnitedHealthcare’s self-funded and fully insured plans. The annual report used claims filed from November 2024 to October 2025 and paid through January 2026. Top findings from the…
Health systems boost front-end collections
Amid rising bad debt, health systems are improving front-end collections, according to surveys. Pre-service collections as a share of self-pay collections have improved from an average of 16% in 2025 to 21% in 2026, which signals that more organizations are capturing revenue successfully before care is delivered, according to a survey of 205 healthcare revenue…