Gail Wilensky: How the pandemic created 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…
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…
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.
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…
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…
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…
Senate bill would give hospitals a big break from looming Medicaid disproportionate share hospital cuts (updated)
Nov. 15 update: On Nov. 14, the House passed legislation on a bipartisan basis to keep the government funded through Jan. 19. Medicaid disproportionate share hospital payments would be guaranteed to remain at their full amount through that date, and the bill similarly maintains short-term funding for graduate medical education, community health centers and the…
Medicare’s hospital outpatient payment rate for 2024 improves marginally from the proposed rule
The final rule setting Medicare’s 2024 payment rates and policies for hospital outpatient services and ambulatory surgical centers (ASCs) contained no major surprises and little to make hospitals optimistic about the government portion of their payer mix. Here are five of the most important payment and coverage takeaways from the rule, which totals 1,672 pages…
Medicare’s final $9 billion remedy plan for 340B providers doesn’t address hospitals’ key concerns
Hospitals received final details on a $9 billion remedy payment plan for participants in the 340B Drug Pricing Program, with advocates expressing disappointment that corresponding reductions to other payments will go through as previously proposed. CMS issued a Nov. 2 final rule describing the terms of the remedy payment, which was necessitated after the Supreme…
Leveraging investments to strengthen resilience: Key insights
The approach health systems take to balance sheet and treasury management varies significantly. One company's managing director dives into how organizations can take a balanced-scorecard method to investments using a tier system.