Healthcare Operations Management News

CMS finalizes changes to the price transparency penalty, inpatient-only list and more for 2022

Medicare policies affecting price transparency, the inpatient-only list and more will take effect Jan. 1 after CMS published its 2022 final rule for hospital outpatient departments and ambulatory surgical centers.

By Nick Hut November 7, 2021

Payment approaches to addressing health equity are seen in a new Medicare rule for kidney care

Updates to a Center for Medicare & Medicaid Innovation care model for end-stage renal disease include an equity-related bonus payment and associated changes to benchmarking.

By Nick Hut October 31, 2021

The impact of COVID-19 further shows the need to modify federal pay-for-performance models, hospital advocate says

Quality measures derived during the COVID-19 pandemic are not an accurate gauge of hospital performance in federal programs such as Value-Based Purchasing.

By Nick Hut October 29, 2021

Currance: Transforming revenue cycle outcomes using AI technology

One company’s AI technology solution helps revenue cycle teams with tools to deliver 2% to 6% additional earned revenue to healthcare systems’ bottom line.

By HFMA October 26, 2021

The Medicare area wage index likely needs a revamp, MedPAC members say

Wage index adjustments leave some hospitals at a disadvantage and are costly for the Medicare program, according to policy advisers.

By Nick Hut October 25, 2021

Addressing U.S. healthcare system challenges requires a focus on improving health, not just care

If we are to effectively address the huge cost challenges facing the U.S. health system, we must begin to better address the cost effectiveness of health, says Todd Nelson, HFMA’s director of professional practice and partner relationships. And it has to be through a collaborative process involving all stakeholders, he says, including not just hospitals and health systems, physicians and health plans but also patients and their communities, as well as society overall.

By Eric C. Reese, PhD October 22, 2021

Study shows reduction in hospital readmissions, costs for medically complex patients seen in an outpatient critical care transition clinic

In a recent study, a large group of patients with medically complex chronic conditions were referred to and seen at an Indianapolis-based outpatient critical care transition clinic saw fewer posthospital inpatient admissions and realized decreased costs of care when compared with those who were referred but did not attend the clinic. HFMA’s Shawn Stack provided insight into the importance of the study.

By Deborah Filipek October 22, 2021

Research highlights ways to save more than $250 billion per year through healthcare administrative simplification

Savings can be generated at the organizational and healthcare industry levels through steps to reduce wasteful administrative processes, study authors wrote.

By Nick Hut October 22, 2021

Healthcare News of Note: Healthcare insurers owe hospitals billions of dollars in payments and are putting more patients in a bind with retroactive claim denials, says Kaiser Health News

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Insurers are behind in billions of dollars in payments to hospitals, the strain on clinicians and staff grows amid the pandemic, and CFO duties involve more digital activities and investor relations.

By Deborah Filipek October 19, 2021

With substantial Medicare payment cuts pending, medical groups call for Congress to act

Payment cuts scheduled for 2022 would amount to a 9.75% reduction in Medicare revenue for medical groups, which are calling on Congress to pass legislation to stop the cuts.

By Nick Hut October 14, 2021
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