Medicaid DSH Third-Party Payer Proposed Rule Summary
HFMA presents a detailed summary of the proposed rule that would address legislative changes to the hospital-specific limit on Medicaid DSH payments as a result of the Consolidated Appropriations Act, 2021.
Medicare DSH Adjustment and Section 1115 Waiver Days Proposed Rule Summary
HFMA presents a detailed summary of the proposed rule published by CMS that would change the policies on how the Medicare disproportionate share adjustment is determined, relating to the counting of days associated with individuals eligible for certain benefits provided by section 1115 demonstrations.
Financial and operational pressures continue for hospitals amid some positive signs
New 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…
Affordability of healthcare is not enhanced when providers form health systems, studies find
The efficiencies gained when providers operate as a health system don’t always translate to care that is more cost-effective, according to two recently published JAMA studies on pricing. In one study, researchers with Harvard Medical School and the National Bureau of Economic Research (NBER) examined 2018 data from various sources, including CMS administrative data, IRS…
2022 midterms aftermath: Gridlock or bipartisanship?
Studies conducted over the past several years have found the polarization is increasing in American society.a And not surprisingly, the 2022 midterm elections reflected the deep divisions. Two fiercely contested Senate seats in this past election are emblematic. Democrat John Fetterman won Pennsylvania’s hotly contested Senate race over Republican Mehmet Oz, MD, taking over the seat…
Monument Health revamps its revenue cycle leadership structure for the benefit of patients and the organization
Looking to break through the cultural silos that can hamper operations at hospitals and health systems, Monument Health has engineered a new brand of clinical-finance collaboration. Headquartered in Rapid City, South Dakota, the community-based health system established a dyad leadership structure in which a clinical leader has joint oversight of the revenue cycle. It’s a…
News Briefs: Healthcare industry disrupter CVS Health to shell out billions to buy Oak Street Health
A month after stating it hoped to gain a presence in primary care, CVS Health accomplished that goal with a massive deal that could fortify its efforts to advance value-based payment in healthcare. The proposed $10.6 billion acquisition of Oak Street Health, a provider of senior-focused primary care, adds to a portfolio of assets that…
4 reasons why now is the time to revisit value-based care
Lessons from the pandemic, investment trends, shifts in Medicare policy, and technological change suggest that now may be the time to reconsider and revisit value-based care. Value-based care has been a hot topic for years now. Every conference, every industry meeting and every publication has talked about the importance of moving “from volume to value.”…
Hospital price transparency update: Regulatory enforcement soon could become stricter, CMS leaders say
Although nothing is official, CMS leaders indicate enforcement of hospital price transparency regulations is set to become more stringent. For an article published in Health Affairs, the Center for Medicare’s Meena Seshamani, MD, PhD, director, and Douglas Jacobs, MD, chief transformation officer, touted progress that has been made since the rules took effect Jan. 1,…
In federal ACO programs, advocates see signs of slow but steady progress
Growth in accountable care organization (ACO) programs has been inconsistent since the Affordable Care Act made accountable care part of the healthcare lexicon in 2010. Nonetheless, proponents are optimistic about the state of ACOs and their potential in upcoming years, even if there’s uncertainty about CMS’s ability to achieve its stated goal of ensuring every…