Payment Reimbursement and Managed Care

Published data quantify how cost increases will continue to affect the healthcare industry next year

The cost to treat patients will accelerate next year, with ramifications across the healthcare industry, according to newly published projections. PwC’s Health Research Institute reported that the cost of providing care will increase by 7% in 2024, up from a 6% increase this year and 5.5% in 2022. A 7% increase would tie 2021 for…

Nick Hut September 7, 2023

HFMA Comments on Hospital OPPS: Proposed Remedy for the 340B-Acquired Drug Payment Policy for CYs 2018–2022

HFMA presents its comment letter to CMS on the proposed rule, Medicare Program; Hospital Outpatient Prospective Payment System: Remedy for the 340B-Acquired Drug Payment Policy for Calendar Years 2018–2022.

HFMA September 7, 2023

A crisis of faith regarding value-based care

As the movement to reduce or eliminate fee-for-service payment in favor of value-based payment plods along, some in the industry are voicing doubts that it is ever going to happen or that it is even necessary.  An HFMA survey conducted in February and March for the “Healthcare 2030” series of special reports finds some of…

Paul Barr, MS, MBA August 31, 2023

The evolution of telehealth and the potential for sustainability

The surge in use of telehealth services seen during the pandemic has slowed, but telehealth remains a key modality amid policy changes that will help set the course for the future of virtual care. “There’s no alternative,” said Kyle Zebley, senior vice president for public policy with the American Telemedicine Association (ATA) and executive director…

Elizabeth Barker August 30, 2023

Summary: 10 vital responses to healthcare disruption

Note: This article is a summary of a report on HFMA’s Spring Thought Leadership Retreat. The full report is available to download. Disruption is reverberating throughout the healthcare industry, and it’s incumbent on legacy organizations to develop strategic responses for the benefit of their consumers, their communities and themselves. With that overarching challenge becoming ever…

Nick Hut August 30, 2023

FY 2024 IPPS/LTCH Final Rule Summary

HFMA presents a detailed summary of the final rule released by CMS describing federal FY 2024 policies and rates for Medicare’s inpatient prospective payment system and the long-term care hospital prospective payment system.

HFMA August 30, 2023

News Briefs: Hospitals foresee adverse impacts from the FY24 inpatient payment rule

The FY24 final rule for Medicare inpatient payments didn’t bring hospitals the type of rate update they had sought, and for some organizations, a bigger concern is changes to uncompensated care (UC) payments. The regulations, which take effect Oct. 1, establish a 3.1% increase in operating payment rates, on average, for hospitals that meet quality-reporting…

Nick Hut August 30, 2023

Prices of drugs for diabetes, heart failure and more will be up for negotiation in Medicare next year

The U.S. Department of Health and Human Services (HHS) on Tuesday announced the first 10 Medicare Part D drugs that will be subject to price negotiations, the headlining healthcare-related provision of the Inflation Reduction Act. Signed in August 2022, the law gave Medicare authority to negotiate with drug manufacturers over the prices of selected drugs.…

Nick Hut August 29, 2023

Leverage healthcare price transparency data to promote financial sustainability

Healthcare organizations are encouraged to review strategies and how to collaborate with payers, among other insights in this article, in order to grow healthcare consumer trust, engagement and retention.

HFMA August 28, 2023

Healthcare News of Note: Latino, Black and Asian people ‘significantly more likely’ to enroll in Medicare Advantage

Among beneficiaries of color, Medicare Advantage enrollees are demographically and geographically different from those in fee-for-service Medicare. Turnover among hospital CEOs has trended downward since hitting 20% in 2013. Eleven of the 100 U.S. hospitals to earn NRC Health’s Consumer Loyalty Award were also honored with the organization’s Consumer Loyalty “Best in Class” Award for…

Deborah Filipek August 28, 2023
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