Healthcare News of Note: The healthcare sector was targeted by nearly 24% of cyber-attack activity in 2022
When it comes to the number of malicious cybersecurity events targeting customers in the Americas, the healthcare industry is second, just behind finance. Contrary to its previously announced plans, the U.S. Department of Justice is not pursuing a further challenge to UnitedHealth Group’s purchase of Change Healthcare. The average pay for physicians decreased 2.4% in…
CMS and other stakeholders take steps to improve prior authorization in Medicare Advantage and beyond
Several recent developments point to an industrywide effort to ease the burden of prior authorization. Most notably, CMS on April 5 finalized a rule that includes provisions designed to improve prior authorization in Medicare Advantage (MA) starting with the 2024 plan year. The rule addresses a few aspects of prior authorization, among them the way…
Court decision means cost sharing could be reinstated for some preventive healthcare services
Comprehensive coverage of some preventive care services could be jeopardized by a recent court ruling. Since its passage, the Affordable Care Act (ACA) had required health plans to cover the full cost of services that received an “A” or “B” rating from the U.S. Preventive Services Task Force (USPSTF). A federal judge in Texas ended…
Maryland’s all-inclusive population health payment model continues to show promise, but nonhospital spending poses a concern
An innovative payment model for Maryland healthcare providers has improved utilization, cost and quality thus far, but an increase in nonhospital spending requires further study. The Center for Medicare & Medicaid Innovation (CMMI) released an analysis of the first three years of Maryland’s Total Cost of Care Model, an effort to improve population health management.…
News Briefs: Financial and operational pressures continue for hospitals amid scattered positive signs
Recent financial data for the hospital industry illustrate continuing challenges even as some trends improve. Fitch Ratings released an analysis in early March that offers scant reason for optimism. Titled “Early NFP hospital medians show expected deterioration; will worsen,” it draws on data from hospitals with earlier 2022 financial year-ends. Those numbers show “materially weaker…
Robert Turner: Avoiding a bond covenant default takes aggressive action from a health system borrower
Not-for-profit hospitals and health systems have faced an increasingly difficult operating environment since inflation began to grow in mid-2021. Last year was particularly hard, beginning with a new wave of COVID-19 infections caused by the omicron variant, and followed by mounting expenses, staffing shortages, rising interest rates and investment losses. As a result, Kaufman Hall…
Reports on patient safety indicate progress, challenges and a need to focus on pediatric mental health
Recent reports add context to the issue of patient safety in hospitals and health systems. ECRI released a report that ranks the pediatric mental health crisis as the No. 1 patient safety issue in healthcare. The report cites a JAMA study that found increases of 29% in anxiety and 27% in depression between 2016 and…
Best practices for relieving unprecedented cost pressures facing healthcare providers
Due to labor cost increases, inflation, declining Medicare reimbursements and other reasons, health systems across the nation are feeling a new financial strain after the height of the pandemic.
Healthcare News of Note: Medicare to negotiate reduced prices for 40 drugs by 2028, says study
Medicare drug price negotiation has the potential to benefit Medicare beneficiaries across some of the most common disease states.
Healthcare News of Note: Most board members of the nation’s top hospitals work in finance or business
Less than 15% of board members at a sampling of the nation’s top hospitals are health professionals, while 56% work in finance or business. Since 2014, the number of medically disenfranchised people in the U.S. nearly doubled from 56 million to over 100 million, causing stress for providers and lower rates of immunization and rising…