FY 2023 Inpatient Prospective Payment System/LTCH Proposed Rule Summary
HFMA presents a detailed summary of the proposed rule updating policies and payment rates to inpatient prospective payment system hospitals and long-term care hospitals.
Finding solutions to better manage payment process workflows
In this roundtable, revenue cycle leaders share their challenges, how they have enhanced payment processes through automation, and how they have identified opportunities for improvement.
OIG calls out issues with denials of payment and services in Medicare Advantage
Medicare Advantage processes related to prior authorization hamper beneficiaries’ access to medically necessary care, according to a new report from the HHS Office of Inspector General.
Tentative deal to provide pandemic funding won’t replenish the COVID-19 Uninsured Program
A bipartisan Senate bill would pay for additional vaccines and therapeutics but wouldn’t restore funding to a program that reimburses providers for furnishing COVID-19-related services to the uninsured.
News Briefs: Biden administration will apply closer scrutiny to healthcare billing practices
A monthly roundup of top news for healthcare finance professionals.
IPPS FY23 proposed rule: CMS seeks to bolster maternal health through a new public-facing hospital designation
Hospitals could attain the “Birthing Friendly” designation by attesting to having implemented best practices in maternal health.
Cost Effectiveness of Health Report, April 2022
The April 2022 edition of HFMA’s Cost Effectiveness of Health Report includes a preview the May issue of hfm, which focuses on telehealth, a key tool for promoting value-based care CEoH. Another article explores ways to promote health equity in revenue cycle processes, and a case study describes how one health system embarked on an initiative to achieve greater diversity among its revenue cycle staff.
Why ensuring the appropriate assignment of observation status patients is so important
Managing observation status requires a focused and consistent effort. Inappropriate assignment of observation status is expensive for patients and hospitals alike and can impede the goal of providing patients with the right care at the right time in the right setting.
David Johnson: Cracks in the foundation (Part 4): Overcoming a brittle business model
U.S. health systems’ rely on centralized, high-cost platforms (e.g., hospitals) to deliver routine care in an approach focused on optimizing revenues under fee-for-service payment. Yet this approach is inefficient and asset-heavy. To build less brittle, more consumer-centric delivery platforms, health systems must decant procedures to more convenient, lower-cost locations as they pursue full-risk contracting.
IPPS FY23 proposed rule: Medicare proposes changes to methodology for determining graduate medical education payments to teaching hospitals
The biggest change is an effort to comply with a court ruling on weighted FTE slots, while another change affects sharable slots for certain rural hospitals.