Healthcare pricing update: 2 experts call for greater regulation
Recent price increases have been slower in healthcare than in the economy at large, but two healthcare economists say the long-term price trends should be addressed through regulation.
How to create an employer-friendly healthcare center of excellence
Increasing health expenditures and the pressures of the recent pandemic have contributed to the development of a new type of center of excellence (COE), called the future-state COE, which is designed to better address the needs of large employers. This COE model incorporates value-based contracting and a strong incentive design into a service-line strategy to create employee health programs that benefit employers, patients and providers alike.
News Briefs: CMS plans to reinstate policies pertaining to the inpatient-only and ASC covered-procedures lists
A roundup of the top news affecting healthcare finance professionals.
Research examines whether financial challenges facing hospitals with large Medicare populations lead indirectly to cost shifting
Harvard researchers found evidence to suggest that hospitals with large shares of Medicare patients are at greater risk of being acquired, which can skew the market structure and lead to higher commercial prices.
Study: In price negotiations with hospitals, self-insured employers lack leverage
The vast difference in market power between hospitals and employers leaves the latter group with little recourse in negotiations, according to a new study.
Healthcare CFOs should ensure their organizations’ contracts are well administered to avoid financial risk exposure
Administering contracts is a core activity for healthcare organizations, given that contracts collectively reflect the organization’s business obligations, including all assets, relationships and terms it is required to manage. It therefore is an important concern for the senior finance leader.
Transitioning health systems to accepting more risk: Key steps to ensuring financial sustainability
The COVID-19 pandemic has renewed many health systems’ interest in pursuing population health initiatives. Yet success with such initiatives will remain elusive if they do not address two common barriers to success: lack of aligned incentives and insufficient infrastructure.
Continued growth in employer-paid healthcare premiums may spur employers to find alternative solutions
HFMA's Chad Mulvany says large employers have signaled a possible end to their patience for traditional players to provide a traditional solution, and he reviews what solutions they could pursue instead.
Healthcare organizations should expect a surge in managed care audits and reviews in the COVID-19 aftermath
Healthcare providers should prepare for emerging trends in payer audits, reviews and associated information requests, after the brief lull in such activities that occurred with the onset of the COVID-19 pandemic.
How to lay the foundations for success under CMS’s new MDC program
The CMS Medicare Direct Contracting (MDC) program offers hospitals and health systems a unique opportunity take the next step in value-based payment and population health management. Success requires the right targeted investments in expertise and infrastructure.