The Provider Relief Fund distribution formula may have left some higher-need hospitals at a disadvantage, study finds
Critical access hospitals generally received lower allocations from a targeted distribution pool compared with hospitals that had a better asset mix.
The Medicare area wage index likely needs a revamp, MedPAC members say
Wage index adjustments leave some hospitals at a disadvantage and are costly for the Medicare program, according to policy advisers.
Addressing U.S. healthcare system challenges requires a focus on improving health, not just care
If we are to effectively address the huge cost challenges facing the U.S. health system, we must begin to better address the cost effectiveness of health, says Todd Nelson, HFMA’s director of professional practice and partner relationships. And it has to be through a collaborative process involving all stakeholders, he says, including not just hospitals and health systems, physicians and health plans but also patients and their communities, as well as society overall.
Hospitals and Congress propose improvements to prior authorization processes in Medicare Advantage
The American Hospital Association says pending regulations that would affect prior authorization should be expanded to include Medicare Advantage.
Research highlights ways to save more than $250 billion per year through healthcare administrative simplification
Savings can be generated at the organizational and healthcare industry levels through steps to reduce wasteful administrative processes, study authors wrote.
Accountable care models will be almost universal for Medicare and Medicaid beneficiaries by 2030, CMS leaders say
A forthcoming revamp of federal value-based payment models will include features designed to encourage provider participation, CMS and CMMI leaders said.
Requirements Related to Surprise Billing, Part II Summary of Interim Final Rule with Comment
HFMA presents a detailed summary of the interim final rule with comment period building on regulations issued in the July 2021 IFC to implement provisions of the No Surprises Act.
Hospital groups express concern over earlier court ruling that could expand False Claims Act liability
The groups argue that allowing FCA claims to be brought for post-termination actions would defy congressional intent and leave hospitals subject to excessive financial liability.
Healthcare News of Note: Healthcare insurers owe hospitals billions of dollars in payments and are putting more patients in a bind with retroactive claim denials, says Kaiser Health News
Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Insurers are behind in billions of dollars in payments to hospitals, the strain on clinicians and staff grows amid the pandemic, and CFO duties involve more digital activities and investor relations.
With substantial Medicare payment cuts pending, medical groups call for Congress to act
Payment cuts scheduled for 2022 would amount to a 9.75% reduction in Medicare revenue for medical groups, which are calling on Congress to pass legislation to stop the cuts.