FY 2024 Hospice Wage Index and Payment Rate Update Proposed Rule Summary
HFMA presents a detailed summary of the proposed rule updating the Medicare hospice payment rates, wage index, the cap amount, and the quality reporting requirements for federal fiscal year (FY) 2024.
Healthcare News of Note: What can be done to correct data disparities in women’s health?
The prevalence of women’s health conditions is roughly five times that of their documented diagnoses, which means for every woman diagnosed with a women’s health condition, roughly four go undiagnosed. The 2023 emergency medicine Match will see 555 initially unmatched positions, affecting a larger number of residency programs than in 2022, when 219 unmatched positions…
State of Medicare: Some good news on program solvency still leaves questions and challenges
Medicare should remain solvent a little bit longer than previously anticipated, while a policy debate is ramping up over how to make the program sustainable for the long term. The 2023 annual report of the Medicare Boards of Trustees projects that the Hospital Insurance (HI) trust fund, which subsidizes Part A services, essentially will be…
David Johnson: Academic medicine, where privilege compounds dysfunction
Academic medicine combines healthcare with higher education, the two U.S. economic sectors that have exhibited outsized cost growth over the past 50 years. The result is a stunning disconnection between academic medical center (AMC) business practices and the supply-demand dynamics reshaping healthcare delivery. Market, technological and regulatory forces are pushing the healthcare industry to deliver…
Medicare’s proposed FY24 update to inpatient payments falls short, hospitals say
Hospitals are less than pleased with Medicare’s proposed FY24 payment update for inpatient care. In proposed regulations, the net inpatient payment update is 2.8% after factoring in a mandatory productivity adjustment of -0.2 percentage points. As usual, the update would be reduced for any hospital that does not fulfill quality-reporting requirements or qualify as a…
CMS and other stakeholders take steps to improve prior authorization in Medicare Advantage and beyond
Several recent developments point to an industrywide effort to ease the burden of prior authorization. Most notably, CMS on April 5 finalized a rule that includes provisions designed to improve prior authorization in Medicare Advantage (MA) starting with the 2024 plan year. The rule addresses a few aspects of prior authorization, among them the way…
Beyond the News: What the end of the PHE means for Medicaid
HFMA Senior Editor Nick Hut and HFMA Policy Director Shawn Stack discuss the end of the public health emergency and what it means for Medicaid as well as a recent blog post from Stack on price transparency.
Court decision means cost sharing could be reinstated for some preventive healthcare services
Comprehensive coverage of some preventive care services could be jeopardized by a recent court ruling. Since its passage, the Affordable Care Act (ACA) had required health plans to cover the full cost of services that received an “A” or “B” rating from the U.S. Preventive Services Task Force (USPSTF). A federal judge in Texas ended…
Maryland’s all-inclusive population health payment model continues to show promise, but nonhospital spending poses a concern
An innovative payment model for Maryland healthcare providers has improved utilization, cost and quality thus far, but an increase in nonhospital spending requires further study. The Center for Medicare & Medicaid Innovation (CMMI) released an analysis of the first three years of Maryland’s Total Cost of Care Model, an effort to improve population health management.…
News Briefs: Financial and operational pressures continue for hospitals amid scattered positive signs
Recent financial data for the hospital industry illustrate continuing challenges even as some trends improve. Fitch Ratings released an analysis in early March that offers scant reason for optimism. Titled “Early NFP hospital medians show expected deterioration; will worsen,” it draws on data from hospitals with earlier 2022 financial year-ends. Those numbers show “materially weaker…