Hut and Stack analyze OPPS and IPPS
Nick Hut and Shawn Stack discuss OPPS and IPPS, and Aaron Shimoff from Athena Health discusses how to stay on course in an ever-changing healthcare landscape.
Only in America could arguments for cutting healthcare access be so artful
The phrase “only in America” usually refers to the upside of national exceptionalism, but in the context of healthcare, the meaning is often negative. That’s the case with current efforts to cut Medicaid — now the nation’s largest healthcare program in terms of enrollment — to pay for large tax cuts that will primarily benefit…
Taking a pulse on healthcare capital investment: 3 insights
Dive into this roundtable to discover the trends shaping market activity and how to accelerate healthcare investments — including support from private equity and venture capital partners.
In comments, for-profit hospital leaders don’t dwell on ‘Big Beautiful Bill’ impact
Leaders of for-profit hospital chains ranged from noncommittal to confident in recent remarks about impending rollbacks to Medicaid and the Affordable Care Act (ACA). Hospitals have several years to prepare for some of the changes, and the interval also leaves time to modify policies in the newly passed budget reconciliation bill, health system leaders said…
Annual Conference Day 3: Some positives for the healthcare industry, but challenges and concerns abound
Amid the challenges of the present moment, it may seem hard to find reason for optimism. But some metrics and trends represent a solid foundation on which not-for-profit hospitals and health systems can brace themselves against the headwinds. “Of the key tenets we look for in the sector, volumes are back to pre-pandemic levels and…
Insurers promise to make prior authorization processes easier for all parties
In potentially a rare dose of good news for providers about prior authorization, the health insurance industry has volunteered to scale back the process and introduce new accommodations, according to an announcement Monday. As described by the insurance lobby and the Trump administration, which convened a meeting Monday at which a large segment of the…
David Johnson: Lessons in solving the nation’s current revenue cycle dilemma
In April 1999, “The Modern Library” published its list of the top one hundred nonfiction books of the 20th century. Number one was “The Education of Henry Adams,” an intellectual autobiography written in 1905 by the great grandson and grandson of John Adams and John Quincy Adams, respectively, the second and sixth presidents of the…
Ken Perez: The NIH research grant cuts — their magnitude, impact and the road ahead
Moves by the Trump administration to reduce HHS’s discretionary budget by 26.2% could have unintended adverse consequences. They not only could undermine the nation’s standing in the field of medical research, but also could derail progress in human health advances, promising medical findings and public health preparedness. Cuts to discretionary spending by the National Institutes…
Modernizing UM: A case for system-level change
For many health systems, utilization management (UM) has long been a functional necessity, but rarely a strategic priority. Originally designed to ensure clinical appropriateness and support payer requirements, UM often grew up within hospital walls, shaped by local workflows and embedded within broader care management structures. As a result, traditional UM functions today are frequently…
How to empower revenue cycle employees to solve problems: a case study of Mass General Brigham
In traditional revenue cycle structures, managers move up the hierarchy because they are good at getting work done and solving problems. However, a successful continuous improvement culture needs not only effective managers but also empowered front-line staff who can share their insights and expertise. With this premise in mind, leaders at Mass General Brigham (MGB)…