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…
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…
Healthcare News of Note: 5% of U.S. adults are forgoing healthcare due to transportation barriers
This blog share synopses of three stories for healthcare finance professionals, including Adults with transportation issues forgo needed healthcare and pediatric hospital admissions involving ICU care are increasing.
Labor costs and other concerns dampen the outlook for not-for-profit hospitals this year
Insights from a leading credit-rating agency illustrate the scope of the financial challenges facing not-for-profit hospitals in 2023.
The hospital labor picture could be improving, but a full financial recovery isn’t imminent
The financial and operational stress that has hampered hospitals may be easing in some ways, but probably not enough to qualify as a holiday gift for a beleaguered industry. Recent reports from credit-rating agencies have presented a mixed outlook. For example, Fitch Ratings released an analysis in December showing “incremental signs of improvement” in the staffing situation…
Pandemic brought increases in the number of patients leaving the ED without being seen
Deferred care appeared to become more widespread in the emergency department amid the COVID-19 pandemic, according to a study.
Healthcare News of Note: U.S. hospitals performed 106,474 unnecessary procedures on older adults during the ‘dangerous’ first year of COVID-19
Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: 106,474 unnecessary procedures were performed on older adults in hospitals early in the pandemic, 55% of patients in rural areas relied on telehealth to receive outpatient mental health and substance use services in March-August 2021, and women and people of color with chest pain wait longer to be seen by a physician.
Latest financial metrics for hospitals show reasons for optimism but also persistent challenges
Hospital financial performance partially recovered in March as patient volumes returned to something closer to normal after a significant downturn during the omicron wave.
News Briefs: Report finds unwillingness to get the COVID-19 vaccine drove healthcare job cuts in January
A roundup of top news for healthcare finance professionals.
Research seeks to pinpoint health system characteristics associated with the tendency to ‘overuse’ healthcare
Higher bed counts, fewer primary care physicians and investor ownership are among the characteristics of health systems that tend to overuse healthcare, according to a new study.