Healthcare Finance and Business Strategy

Two massive segments of the healthcare ecosystem operations — nonprofit health systems and nonprofit health insurance companies — have struggled to achieve operations at the national level. These organizations consistently find it difficult and time-consuming to merge, and as a consequence, neither has achieved national scale. This situation compromises nonprofits’ capacity to generate operating economies and create value for their customers.…

The past decade has seen hospital finances whipsawed by a global pandemic, a record-setting multi-hundred-billion-dollar cyberattack, a more than 20-year record surge in labor costs and a trillion-dollar cut in federal Medicaid spending. Not surprisingly, hospital credit has deteriorated. Hospital finances cumulative rating activity, quarterly trend Yet hospital capital spending is soaring.a Capital spending for…

For decades, our nation’s health systems have pursued a strategy of what I call “controlled deceleration,” which acknowledges innovation while slowing it to a pace that has preserved existing power structures. That strategy no longer works. The passage of the One Big Beautiful Bill Act (OBBBA), in combination with other powerful forces, is bringing high-velocity…

Hospital financial performance remained uneven in the second quarter as policy changes and broader economic pressures affected the not-for-profit (NFP) and for-profit segments. In the NFP sector, median health system operating margin ticked upward to 0.4% year-to-date (YTD) through May, according to monthly data from Strata Decision Technology. But the metric wasn’t quite as steady…

Nick Hut discusses the Medicare OPPS Proposed Rule with Kathy Stull. Erika Grotto talks with Michael Driscoll of Fidelity Investments about cost saving strategies for employers and with Tracy Monson from Onbe about modernizing the patient financial experience.

With drug and supply costs continuing to strain margins, hospitals are searching for strategic approaches to mitigate the impact. Drug costs are surging, driven by specialty drugs ranging from GLP-1 products to cell and gene therapies. Citing industry data, Emad Rizk, MD, who recently moved into the top position with Premier Inc., pointed to pharmaceutical…

Healthcare organizations face a familiar challenge: identifying which members are most likely to experience clinical deterioration before costly complications occur. As financial pressures intensify and workforce shortages continue, health plans, employers and provider organizations must allocate limited care management resources with increasing precision. The question is no longer whether organizations should stratify risk — it…

A recently released CMS final rule concerning independent dispute resolution (IDR) mediation likely will cause a further bottleneck of No Surprises Act-based appeals, experts said. In the final rule, the fees were set at $15, down from $115 paid before the proposed rule came out. CMS in its proposed rule had originally set the revised…

HHS discretionary funding in FY27 would decrease by close to 4% from current appropriations, according to a budget proposal that advanced out of the House Appropriations Committee this month. The $110.8 billion allocation would be roughly $4 billion lower than FY26 enacted funding. The budget appears to preserve more funding for traditional programs, relative to…

Monday video recap: AC26 Day 2 Recap: Big Questions, Bold Conversations In this roundup: With government retrenching, the impetus is on healthcare industry stakeholders to bolster sustainability Insights from the ‘affordability czar’ Jordan reflects on HFMA’s history and what lies ahead Vitalic Health session looks at how technology can drive a better system Most health…