In Congress, it’s status quo for Medicaid DSH payments and the Medicare physician fee schedule
Yet another short-term federal funding measure from Congress included yet another brief extension of full funding for Medicaid disproportionate share hospital (DSH) payments. With funding for much of the federal government set to expire Jan. 19, Congress agreed on a continuing resolution that keeps all agencies fully operational until March. Medicaid DSH payments are guaranteed…
Medicare beneficiaries would have new options for appealing their hospital patient status under a proposed rule from CMS
A proposed rule from CMS would affect the appeals process for some patients whose status is reclassified from inpatient to outpatient observation during a hospital stay. After a 2020 court ruling that was upheld at the appellate level in 2022, the U.S. Department of Health and Human Services and CMS were obligated to create additional…
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…
Comparison of 2024 ASC Addendum BB with October 2023 Addendum BB
HFMA presents a spreadsheet comparing ASC covered ancillary services. It also includes an HCPCS lookup tool that makes it easier to pull-up descriptive and payment information for a particular code.
Comparison of 2024 ASC Addendums AA and FF with October 2023 Addendums
HFMA presents a spreadsheet for relative weights and payment rates for the Ambulatory Surgical Center payment system comparing 2024 to 2023 rates.
2024 Physician Fee Schedule Specialty Impact Tables – Updated
HFMA presents an updated specialty impact tables based on the 2024 Medicare Physician Fee Schedule final rule.
Comparison of 2024 Physician Fee Schedule Final Payment Rates to October 2023 Payment Rates – Updated
HFMA presents an updated spreadsheet comparing the 2024 physician fee schedule payment rates to the 2023 payment rates.
An extended year-end policy update with Nick Hut and Shawn Stack
HFMA Senior Editor Nick Hut and HFMA Policy Director Shawn Stack discuss the most pressing end-of-year issues for 2023.
New data on national healthcare spending highlights the constraints facing hospitals
Recently published 2022 data indicates relatively restrained national healthcare spending as the COVID-19 pandemic faded, especially in the hospital sector. The increase in spending on hospital services slowed from 4.5% in 2021 to 2.2% in 2022, CMS actuaries reported Dec. 13 in Health Affairs. The increase was significantly less than in 2020 (6.2%) and the…
House passes bill to codify healthcare price transparency, expand site-neutral payment
The hospital industry saw reason for both relief and disappointment this week after a bill designed to promote price transparency took a major step toward becoming law. The House on Dec. 11 passed H.R. 5378, also known as the Lower Costs, More Transparency Act, by a 320-71 vote. Along with cementing price transparency as the…