Denials Management Research Report
HFMA, with sponsorship from Waystar, surveyed 415 healthcare finance and revenue cycle executives to understand how denials are affecting their revenue cycle operations.
Survey reveals 5 opportunities to tackle denial prevention and management
In this survey, responses found when organizations devote greater resources to denial management than to denial prevention, their rate of first-pass denials is higher: 13.6% versus 10.9%.
MedPAC takes aim at the Medicare wage index and reiterates support for site-neutral payment
In its semiannual report to Congress, the Medicare Payment Advisory Commission (MedPAC) recommends significant changes to two key aspects of Medicare policy: the wage index and site-neutral payment. 1. A revamp of the wage index The wage index consistently generates concern among healthcare stakeholders, including in Medicare’s FY24 proposed rule for hospital inpatient payments. According…
HFMA Annual Conference preview: How Vanderbilt University Medical Center built a successful bundled payment program
Dr. Brittany Cunningham from Vanderbilt University Medical Center discusses her upcoming presentation at HFMA's Annual Conference in Nashville. Also in this episode, strategies for cash flow discrepancies with sponsor organization Inovalon.
Medicaid Drug Misclassification Proposed Rule Summary
The rule proposes to implement policies in the Medicaid Drug Rebate Program (MDRP) related to legislative requirements addressing drug misclassification, as well as drug pricing and product data misreporting by manufacturers.
As anticipated, the start of the Medicaid unwinding process has taken a toll on coverage
Fears among healthcare policymakers that the end of the COVID-19 public health emergency would sow chaos in Medicaid have been realized, leading the Biden administration to intensify its mitigation efforts. The end of Medicaid continuous-enrollment provisions is affecting the program in many states. In 21 states that had begun the “unwinding” process since April 1,…
Medicare coverage and coding updates: New Alzheimer’s drugs to be covered, but not universally
Note: This article was updated July 6. For drugs manufactured to slow the progression of Alzheimer’s disease, Medicare will offer coverage with certain qualifications, according to a recent CMS announcement. The new policy especially is relevant because the FDA’s first full approval of an Alzheimer’s disease drug may be only a month or so away.…
Why it’s so essential for hospitals to embrace a value-based payment strategy
dealing with myriad severe short-term operating strains, such as workforce shortages, to existential threats to their long-term future, including being cast as the enemy in the fight against rising healthcare costs, hospital leaders are struggling to maintain their organizations’ financial sustainability.
Ensuring Access to Medicaid Services Proposed Rule Summary
On May 3, 2023, CMS published in the Federal Register a proposed rule entitled “Medicaid Program; Ensuring Access to Medicaid Services” (88 FR 27960-28089). The rule proposes policies that take a comprehensive approach to improving access to care, quality and health outcomes, and better addressing health equity issues in the Medicaid program across fee-for-service, managed care delivery…
Healthcare News of Note: The top 5 reasons U.S. adults say the nation’s healthcare system fails to meet their needs
Nearly three-quarters of adults say the U.S. healthcare system is not meeting their needs in some way, with the length of time to get an appointment the No. 1 reason. The top benefit of using remote patient monitoring during cancer care is to keep the care team up to date on symptoms in between appointments,…