CMS and other stakeholders take steps to improve prior authorization in Medicare Advantage and beyond
Several recent developments point to an industrywide effort to ease the burden of prior authorization. Most notably, CMS on April 5 finalized a rule that includes provisions designed to improve prior authorization in Medicare Advantage (MA) starting with the 2024 plan year. The rule addresses a few aspects of prior authorization, among them the way…
Reports on patient safety indicate progress, challenges and a need to focus on pediatric mental health
Recent reports add context to the issue of patient safety in hospitals and health systems. ECRI released a report that ranks the pediatric mental health crisis as the No. 1 patient safety issue in healthcare. The report cites a JAMA study that found increases of 29% in anxiety and 27% in depression between 2016 and…
Healthcare News of Note: Most board members of the nation’s top hospitals work in finance or business
Less than 15% of board members at a sampling of the nation’s top hospitals are health professionals, while 56% work in finance or business. Since 2014, the number of medically disenfranchised people in the U.S. nearly doubled from 56 million to over 100 million, causing stress for providers and lower rates of immunization and rising…
How to determine appropriate patient status and navigate observation-level care
The financial implications of ensuring appropriate patient status throughout a hospital stay are substantial, so it is in organizations’ interest to enhance the process.
The media blame game regarding patient financial conversations
Brad Dennison, HFMA chief content executive, discusses the March hfm cover story about patient-friendly payment and what some media organizations get wrong.
Healthcare News of Note: New PCORI initiative targets industry’s slowness in adopting results of comparative effectiveness research
Over the past few weeks, I have found these industry news stories that should be of interest to healthcare finance professionals. 1. Goal of PCORI initiative: Reduce the estimated 17-year wait time to adopt new and better treatments Forty-two health systems have signed on to an initiative to translate new research into changes in…
Hospitals face increased need amid pandemic to improve patient throughput
An acute care hospital cannot begin to be able to deliver cost-effective care if it lacks a fully coordinated approach for moving patients from admission to discharge.
Collecting with compassion: Patient financial care grows in importance
Health system leaders increasingly believe more communication is better when it comes to telling patients what they owe. When the pandemic began, Henry County Health Center’s revenue cycle department took a gamble to relieve the financial stress of care for patients. Executives for the 25-bed, Mount Pleasant, Iowa, critical access hospital, which serves a large…
How R1 RCM’s technology-driven solutions address health system challenges
Seeing challenges in labor shortages, shrinking margins and other complexities? Enter technology-driven solutions for revenue cycle management. Read the details in this peer review spotlight.
Healthcare News of Note: Amazon closes its deal with One Medical, touts opportunity to scale a new primary care model
Amazon closes its deal with One Medical