Continued 340B eligibility is at risk for hundreds of hospitals thanks to pandemic-related factors
Hospitals that rely on savings from the 340B Drug Pricing Program should examine the possibility that they will soon be rendered ineligible. Several factors are having an industrywide impact on the disproportionate share hospital adjustment percentage, and if that tally drops below a certain threshold on a hospital’s Medicare cost report, the hospital cannot receive…
The importance of digital transformation in a fraudulent environment
In this recently conducted survey, more than 85% of responding hospital financial executives said they are somewhat concerned (65.96%) or very concerned (19.15%) about potential AI-influenced fraud, including account takeovers and eventually payment fraud.
How digital patient engagement solutions can help healthcare organizations improve their existing revenue cycle
This roundtable features various healthcare professionals who breakdown what digital patient engagement solutions are being implemented and how this not only empowers patients, but also helps organizations looking to improve their existing revenue cycle.
Healthcare Finance Trends for 2024
Download this eBook to see details of the 10 financial trends that will shape 2024 for hospitals and health systems across the country.
Healthcare Blame Game: Bloomberg Philanthropies puts $250 million into educating new healthcare workers while Patient Rights Advocate spends on spreading misinformation
Chad Mulvany, vice president of federal policy for the California Hospital Association and former HFMA policy director, discusses Bloomberg Philanthropies $250 million investment in the future healthcare workforce, as well as what will actually move the needle on price transparency.
New rule on Medicaid DSH payments will impose stricter limits on many hospitals
Numerous hospitals that receive Medicaid disproportionate share hospital (DSH) payments face a tighter cap on their payment amounts after the Feb. 23 publication of a CMS final rule. The regulations were spawned by 2020 year-end legislation that made changes to the DSH hospital-specific limit (HSL), including with respect to how third-party payments factor into the…
New data shows providers continuing to win most No Surprises Act independent dispute resolution cases
Providers won a large majority of disputes initiated during the first half of 2023 through the No Surprises Act’s arbitration portal for adjudicating out-of-network payments, according to newly published data. HHS and the U.S. Departments of Labor and Treasury released public-use files (available to download here under “2023 Reporting Year”) showing the outcome of every…
Site-neutral payment has backing in healthcare policy circles, but its efficacy as a cost restraint is unclear
The concept of site-neutral payment continues to receive support from members of Congress and healthcare policy analysts, as demonstrated during a recent hearing. The Jan. 31 hearing of the House Energy and Commerce Committee’s Health Subcommittee was intended, in part, to promote pending legislation that would strengthen price transparency and implement other policies designed to…
CMS’s 2025 advance rate notice for Medicare Advantage brings potential concern for providers
Medicare Advantage (MA) health plans are projected to reap a 3.7% revenue increase in 2025, but provider payments could be affected by a decrease in plan benchmarks, per data shared in CMS’s annual advance notice. If finalized, the estimated 0.16% average reduction in base payments to plans could have consequences for care delivery, one provider…
Hospitals say Supreme Court should hear a case that affects disproportionate share hospital payments
Hospital advocacy groups hope the Supreme Court will review a lower-court ruling that has adverse implications for Medicare disproportionate share hospital (DSH) payments. Six groups on Feb. 2 submitted an amicus brief to the Supreme Court regarding an appeals court’s 2023 decision backing HHS’s interpretation of the DSH payment formula. The department long has said…