Employer-sponsored healthcare coverage would benefit from better access to data, Congress is told
Employers can stimulate efforts to improve the value of healthcare, but they need help in the form of better access to claims data and prices, according to testimony at a recent congressional hearing. With those tools in hand, employers can more easily forge provider partnerships that lower costs and raise healthcare quality, health benefit administrators…
Downgrades topple upgrades: 5 key takeaways from rating activity in 2023
As expected, 2023 saw a material increase in downgrades over 2022 while the number of upgrades declined from the prior year. Volume showed favorable growth for many hospitals during 2023, although some indicators remained below prepandemic levels. Other hospitals reported a payer mix shift toward more Medicare as the U.S. population continued to age and…
5 reasons to apply for a prestigious MAP Award for revenue cycle performance
For more than a decade, HFMA’s MAP Award for High Performance in Revenue Cycle has become the highest honor in the healthcare industry for revenue cycle excellence. If that’s not enough of a reason to apply for the chance at these accolades, here are five reasons why past winners apply year after year. 1. Bragging…
How a payer-provider collaboration around quality reporting can reduce costs and improve outcomes
Too often today, relations between provider and payer organizations can become contentious around issues related to payment and quality of care. Yet such conflict does not serve patients well, because it deflects these organizations’ attention from their underlying shared purpose: To work together to deliver well-coordinated, cost-effective healthcare to patients. With this purpose in mind,…
The state of U.S. primary care: How new ways of thinking can spur meaningful improvement
As healthcare stakeholders consider ways to fortify the nation’s primary care system, industry leaders recommend emphasizing several strategies and components — and not waiting to act. “We’re close to midnight in many respects in thinking about how to urgently preserve and expand primary care in America,” Susan Dentzer, president and CEO of America’s Physician Groups…
The big picture for healthcare in 2024, with Andrew Donahue
HFMA Policy Director Andrew Donahue discusses what trends and policy decisions will affect the healthcare industry in this election year.
Healthcare News of Note: CDC urges healthcare providers to boost flu, COVID-19 and RSV vaccinations, and some hospitals require masking as respiratory illnesses spread
Over the past few weeks, I have found these recent industry news stories that should be of interest to healthcare finance professionals. 1. CDC urges providers to boost flu, COVID-19 and RSV immunizations; mask mandates return for some healthcare facilities “As the new year takes off, CDC continues to track the rise of JN.1…
Recent updates and emerging best practices for ACOs in the Medicare Shared Savings Program
Going into the 12th year since it brought accountable care into the healthcare lexicon, the Medicare Shared Savings Program (MSSP) continues to evolve, with CMS making changes and participants fine-tuning best practices. Starting with 220 accountable care organizations (ACOs) in 2012-13, the MSSP grew to 561 in 2018. However, the number has been below 500…
Experts forecast a busy year for healthcare M&A even with changes to regulatory oversight
A more exacting system for regulatory reviews is a factor in the short-term outlook for healthcare mergers and acquisitions. New M&A guidelines from the Federal Trade Commission (FTC) and the U.S. Department of Justice (DOJ) add a wrinkle to the process of consummating deals, especially in the short term as the parties adjust to the…
2024 outlook: Hospitals can expect a steadier year financially, but key questions loom
Although the past year brought more stability for the not-for-profit hospital sector, analysts foresee 2024 as a pivotal period in determining the viability of individual organizations. Fitch Ratings continues to describe the sector’s outlook as “Deteriorating.” In a year-end report, the credit-rating agency said downgrades of hospitals and health systems in 2023 had outpaced upgrades…