Employers find success in healthcare savings through TPA shift and payment integrity
The Health Transformation Alliance (HTA) has identified three approaches that have saved its member companies the most in healthcare expenditures, including switching to TPAs, shifting to a full pass-through pharmacy benefit manager, and pushing payment integrity.
Congress pressures CMS to implement No Surprises Act requirements
CMS is expected to implement long-delayed transparency rules for payers and providers, including Good Faith Estimates and Advanced Explanation of Benefits, in 2026, after years of pressure from Congress and industry stakeholders.
Hospitals brace for leaner contracts as Medicare Advantage plans face financial pressures
Medicare Advantage plans are projecting a 900,000 drop in enrollment in 2026, which could have negative consequences for hospitals and health systems due to plans under increased financial pressure pushing administrative requirements.
AI adoption in healthcare finance lags despite claims process promise
Despite two-thirds of healthcare finance professionals seeing the promise of AI to improve the claims process, only 14% have implemented it on claims denials, due to concerns about accuracy, HIPAA compliance, and complexity of training teams.
FastFinance: How employers are cutting healthcare costs
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. An employer group identifies the most effective cost-cutting approaches large businesses have found for their employee healthcare coverage. Also, this week’s Weird Number: $1.7 billion is available for hospitals from the…
CMS proposal for 340B repayment sparks concerns over hospital funding cuts
Hospital advocates have raised concerns about the proposed Medicare payment rule's accelerated clawback of 340B-related payments, which could cost hospitals billions of dollars in cuts and lead to reduced patient services.
Democrats push for $1.4 trillion spending boost, risking federal shutdown
Congressional Democrats are pushing for a $1.4 trillion increase in federal spending, with the majority of the funds going towards healthcare, in order to pass a continuing resolution and avoid a federal government shutdown on October 1st.
CMS warns it may reject state-directed payments
CMS will now reject SDP submissions from states that fail to provide complete evaluation plans and demonstrate how the payments advance managed care quality goals.
Private equity ownership boosts hospital profitability through staff cuts
Private equity-acquired hospitals have been found to have improved financial results and survival rates, with decreased wage costs and increased profitability, but also decreased patient satisfaction and potential adverse surgical outcomes.
The latest on budget talks, rural healthcare funding and a controversial payment policy
HFMA Senior Editor Nick Hut and HFMA Policy Director Shawn Stack discuss the latest in healthcare finance news. Also in this episode, Brad Dennison, HFMA’s Vice President of Content, talks with Rich Daly about the new Fast Finance podcast.