Finance and Business Strategy

Walmart Health’s demise is emblematic of the nation’s primary care conundrum

Walmart’s announcement on April 30 that it was pulling the plug on Walmart Health stunned the healthcare ecosystem.a Few saw it coming. Launched amid much fanfare in 2019, Walmart Health has operated 51 health centers in five states, with a robust virtual care platform. Walmart’s news release noted that “the challenging reimbursement environment and escalating…

David W. Johnson June 19, 2024

Health system success depends on effective integration of APPs

Effectively leveraging advanced practice providers (APPs) within a health system’s ambulatory and inpatient settings can improve patient access and throughput and support volume growth. APPs have a rapidly growing presence within the clinical workforce. Consider these statistics: With median salary and fringe benefits for APPs approaching $200,000 a year, health system leaders can no longer…

Bonnie Proulx, DNP, APRN, PNP-BC June 19, 2024

Personalized communication helps State provide the highest possible recovery and patient-satisfaction rates for clients

Learn about a company that combines advanced technology with human interaction to increase recoveries and patient satisfaction.

HFMA June 4, 2024

News Briefs: A second appeals court rules against providers in the 340B contract-pharmacy dispute

A decision issued by an appeals court represents the latest setback for 340B providers seeking to secure price discounts on Medicare Part B drugs. The D.C. Circuit Court of Appeals on May 21 upheld a district-court ruling that drug manufacturers can impose restrictions on the 340B discounts they provide for drugs dispensed at contract pharmacies.…

Nick Hut June 3, 2024

HFMA’s editorial team earns 19 awards for excellence

HFMA has been honored with a total of 19 awards of excellence for various editorial pieces produced and published in 2023. The recognized pieces were as follows: “We know the original content our editorial team produces, including hfm, online posts, blogs, monthly newsletters and podcasts, is valuable to our members because you tell us so…

Deborah Filipek June 3, 2024

How one health system focused on revenue cycle staff education to improve its denial rate

Many longtime revenue cycle leaders can recall a simpler time when insurance companies sold plans that were broadly accepted by providers in their service areas. Back then, hospitals provided services to patients, billed their health insurance plans and expected relatively prompt payment. This is no longer true. Today’s revenue cycle team members must be knowledgeable…

Kristen Shoup, CHFP, MBA, RHIA June 3, 2024

What health systems need to know about partnering to develop an ASC strategy

Health systems must contend with conflicting imperatives. While remaining intensely focused on day-to-day operations and financial viability, they cannot ignore longer-term strategic imperatives, which may include building out a full continuum of care to succeed under value-based payment while maintaining market relevance. Yet many health systems face significant impediments to broadening the continuum of care,…

Daniel M. Grauman, MBA, CPA/ABV June 2, 2024

The key role of downside risk in the success of value-based care

The basic idea behind value-based care (VBC) is simple. By encouraging providers to focus on the value rather than the volume of the services they deliver, it should be possible to achieve the twin goals of lowering healthcare costs and improving clinical outcomes. Given that the United States now spends far more per capita on…

Richard Jackson June 2, 2024

Lessons learned from the Change experience

As is now well known, Change Healthcare, a 2022 acquisition by UnitedHealth Group (UHG), was hacked this past February. For nine days, hackers were able to gain access to and maneuver through Change Healthcare’s files at will before it became clear that the system had been compromised. According to a report from the Congressional Research…

Gail R Wilensky, PhD June 2, 2024

A new DOJ task force is the latest example of intensified federal oversight of healthcare antitrust issues

A new task force at the U.S. Department of Justice (DOJ) is likely to bring additional scrutiny on whether healthcare transactions adversely affect competition. The department’s Antitrust Division announced the formation of a group to “consider widespread competition concerns shared by patients, healthcare professionals, businesses and entrepreneurs, including issues regarding payer-provider consolidation, serial acquisitions, labor…

Nick Hut May 29, 2024
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