Operations Management

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…

Nick Hut January 9, 2024

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…

Nick Hut December 22, 2023

HFMA strategy session highlights challenges and opportunities for healthcare finance leaders: payer relations, supply costs, AI and more

The legacy healthcare provider’s position in the industry could grow tenuous if leaders don’t respond boldly and strategically to ongoing trends, according to insights recently presented to HFMA leaders. “We’re at a crossroads right now,” Ashraf Shehata, principal and U.S. national sector leader for healthcare and life sciences with KPMG, said in November during a…

Nick Hut December 19, 2023

How to achieve savings by reengineering nonclinical healthcare spending

With healthcare margins under constant and growing pressure, hospital and health system finance leaders must continue to explore all avenues for cost savings across their organization. Supply chain savings efforts have traditionally been focused on clinical spending and on contracts accessed via group purchasing organization (GPO) relationships. By looking to nonclinical spending on administrative and…

Keith Noll December 19, 2023

Gail Wilensky: How the pandemic spurred a new impetus for improved care coordination

The COVID-19 pandemic proved to be a catalyst for many significant changes in healthcare delivery. Some were intentional, representing seized opportunities to improve processes. But other changes were forced on the industry as a result of constraints imposed by the pandemic. One of the most significant of these changes, for example, has been the industry’s…

Gail R Wilensky, PhD December 19, 2023

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…

Nick Hut December 12, 2023

The best of 2023 from HFMA’s editorial team

The HFMA editors share their favorite content from this year and provide a glimpse of what's to come in 2024.

Erika Grotto December 4, 2023

Prior authorization in Medicare Advantage remains in the policy spotlight as 2024 regulations take effect

Healthcare policymakers and stakeholders continue to mull the need for guardrails to ensure optimal customer service among Medicare Advantage (MA) health plans. The American Hospital Association wrote a Nov. 20 letter to CMS stating that MA plans are looking to skirt policies designed to ensure straightforward coverage of essential healthcare services. These policies, finalized earlier…

Nick Hut December 1, 2023

Cost Plus Drugs announces its expansion into specialty drugs

If you have ever attended one of my lectures over the past three years, it is very rare that I don’t at least mention Cost Plus Drugs and the impact they have made in the pharmaceutical sales industry. The latest news on Cost Plus Drug Company Just this week, Mark Cuban, the founder of Cost…

Shawn Stack November 29, 2023

Healthcare News of Note: The Leapfrog Hospital Safety Grade shows hospitals ‘significantly’ reduced 3 hospital-acquired infections post-pandemic

Over the past few weeks, I have found these recent industry news stories that should be of interest to healthcare finance professionals.   1.  Healthcare-acquired infection scores improve for hospitals, but patient experience scores continue to decline, says new Leapfrog report Although hospitals are doing better when it comes to reducing healthcare-acquired infections (HAIs) “after significant…

Deborah Filipek November 16, 2023
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