Payment Reimbursement and Managed Care

No Surprises Act end-of-year update: A new administrative fee is set, and the arbitration portal is fully functional

Bringing out-of-network payment disputes to arbitration under the No Surprises Act in 2024 will be less expensive than previously described. In a final rule, the U.S. Departments of Health and Human Services (HHS), Labor and Treasury set the administrative fee for using the independent dispute resolution (IDR) portal at $115 per case, effective 30 days…

Nick Hut December 20, 2023

HFMA strategy session highlights challenges and opportunities for healthcare finance leaders: payer relations, supply costs, AI and more

The legacy healthcare provider’s position in the industry could grow tenuous if leaders don’t respond boldly and strategically to ongoing trends, according to insights recently presented to HFMA leaders. “We’re at a crossroads right now,” Ashraf Shehata, principal and U.S. national sector leader for healthcare and life sciences with KPMG, said in November during a…

Nick Hut December 19, 2023

2024 Physician Fee Schedule Specialty Impact Tables – Updated

HFMA presents an updated specialty impact tables based on the 2024 Medicare Physician Fee Schedule final rule.

HFMA December 19, 2023

Comparison of 2024 Physician Fee Schedule Final Payment Rates to October 2023 Payment Rates – Updated

HFMA presents an updated spreadsheet comparing the 2024 physician fee schedule payment rates to the 2023 payment rates.

HFMA December 19, 2023

An extended year-end policy update with Nick Hut and Shawn Stack

HFMA Senior Editor Nick Hut and HFMA Policy Director Shawn Stack discuss the most pressing end-of-year issues for 2023.

Erika Grotto December 18, 2023

New data on national healthcare spending highlights the constraints facing hospitals

Recently published 2022 data indicates relatively restrained national healthcare spending as the COVID-19 pandemic faded, especially in the hospital sector. The increase in spending on hospital services slowed from 4.5% in 2021 to 2.2% in 2022, CMS actuaries reported Dec. 13 in Health Affairs. The increase was significantly less than in 2020 (6.2%) and the…

Nick Hut December 18, 2023

House passes bill to codify healthcare price transparency, expand site-neutral payment

The hospital industry saw reason for both relief and disappointment this week after a bill designed to promote price transparency took a major step toward becoming law. The House on Dec. 11 passed H.R. 5378, also known as the Lower Costs, More Transparency Act, by a 320-71 vote. Along with cementing price transparency as the…

Nick Hut December 12, 2023

Using analytics effectively to drive margin improvement

Participants of an HFMA Executive Roundtable held June 27 discuss how healthcare providers are taking steps to encourage data sharing among units and create a single source of truth for operational and patient data.

HFMA December 12, 2023

News Briefs: Medicare’s hospital outpatient payment rate for 2024 improves marginally from the proposed rule 

The final rule setting Medicare’s 2024 payment rates and policies for hospital outpatient services and ambulatory surgical centers (ASCs) contained little to make hospitals optimistic about the government portion of their payer mix.  Base payments for items and services furnished in hospital outpatient settings and ASCs will increase by 3.1% after factoring in the usual…

Nick Hut December 12, 2023

RemitConnect® helps healthcare organizations automate manual posting and reconciliation processes

This HFMA Peer Review Spotlight explores the benefits of CommerceHealthcare's RemitConnect solution in complementing a healthcare organization's existing patient accounting or practice management system.

HFMA December 11, 2023
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