James Mathews: U.S. nursing homes face stormy waters amid staffing challenges and an aging population
Readers of a certain age may recall Sebastian Junger’s book A Perfect Storm, which describes the last voyage of the Andrea Gail, a Massachusetts swordfishing boat. In October 1991, the boat encountered a violent storm in the North Atlantic Ocean and was lost with all hands. The storm was borne of three converging meteorological conditions: the remains of Hurricane Grace,…
Nathan Kaufman: Hospital-based anesthesia and radiology operate in a broken financial model
The good ol’ days of hospital-based physicians providing services at no cost in exchange for exclusivity are over, creating significant disruptions. Health systems are facing a growing shortage of anesthesiologists and radiologists, a shortfall that is driven by a broken business model for those types of services. Underpayment for anesthesia and radiology care by Medicare and Medicaid combined with a lack of experience in related revenue cycle management and high…
The power of connection: Redefining healthcare collaboration through payer-provider interoperability
By leaning into a new era of payer-provider interoperability through technology investments and collaborative innovation and communication, healthcare organizations can strengthen health outcomes while building better relationships with consumers. Learn more about critical elements for success in this white paper.
Hospital use and service intensity helped fuel healthcare spending growth in 2024
Increasing use and intensity of hospital care, physician and clinical services, and retail prescription drugs led a continued surge in U.S. healthcare spending in 2024, according to newly released data. National health expenditures (NHE) reached $5.3 trillion, a 7.2% increase year-over-year and comparable with the 7.4% jump recorded in 2023. Except for the pandemic year…
Operational resilience is the revenue cycle management imperative of the OBBBA era
The One Big Beautiful Bill Act (OBBBA) has altered Medicaid eligibility in ways hospitals can no longer treat as a background policy issue. Reverification of Medicaid coverage now happens so frequently that patients lose coverage for administrative reasons that have nothing to do with whether they actually qualify. Much of the industry dialogue has centered…
CMS distributes $10 billion for states to use to improve rural health
CMS awarded states $10 billion in rural health funding for 2026, implementing a widely anticipated provision of the legislation known as the One Big Beautiful Bill Act (OBBBA). The Rural Health Transformation Program (RHTP) funding is intended to help rural healthcare providers succeed amid the projected cutbacks in federal Medicaid funding over the next decade…
What healthcare investors value most today
The healthcare municipal market continues to navigate a mix of structural headwinds, evolving risk appetites and a shifting credit landscape. An investor conversation at the Kaufman Hall Healthcare Leadership Conference in October offers insights as to where investors are focused today and what borrowers can do to meet the market on favorable terms. Three themes…
News Briefs: ACA subsidies in limbo after government funding deal
After Congress ended the longest federal government shutdown on record at 43 days, the future of enhanced subsidies under the Affordable Care Act (ACA) remained unresolved. The shutdown officially ended Nov. 12, three days after eight members of the Senate Democratic caucus joined Republicans to help pass a continuing resolution that maintains spending through Jan.…
Ken Perez: The tariffs-driven trade war and its implications for healthcare
Given President Donald Trump’s use of tariffs and their significant worldwide economic impact, it’s not surprising that the word tariff has been considered a candidate for Word of the Year.a Whether or not you agree with Trump’s tariff policy, the United States has a powerful ability to impose tariffs, rooted in the immensity of the…
David Johnson: Why interoperability is causing Epic to confront a profound identity crisis
Epic currently is the nation’s dominant supplier of electronic health records (EHRs) — the data backbone upon which the U.S. healthcare system operates. The company’s market position has long appeared unassailable. Upon closer inspection, however, Epic’s business model contains the seeds of its own diminution. The company aspires to be a system of record for…