Payment Reimbursement and Managed Care

New data on national healthcare spending highlights the constraints facing hospitals

Recently published 2022 data indicates relatively restrained national healthcare spending as the COVID-19 pandemic faded, especially in the hospital sector. The increase in spending on hospital services slowed from 4.5% in 2021 to 2.2% in 2022, CMS actuaries reported Dec. 13 in Health Affairs. The increase was significantly less than in 2020 (6.2%) and the…

Nick Hut December 18, 2023

House passes bill to codify healthcare price transparency, expand site-neutral payment

The hospital industry saw reason for both relief and disappointment this week after a bill designed to promote price transparency took a major step toward becoming law. The House on Dec. 11 passed H.R. 5378, also known as the Lower Costs, More Transparency Act, by a 320-71 vote. Along with cementing price transparency as the…

Nick Hut December 12, 2023

Using analytics effectively to drive margin improvement

Participants of an HFMA Executive Roundtable held June 27 discuss how healthcare providers are taking steps to encourage data sharing among units and create a single source of truth for operational and patient data.

HFMA December 12, 2023

News Briefs: Medicare’s hospital outpatient payment rate for 2024 improves marginally from the proposed rule 

The final rule setting Medicare’s 2024 payment rates and policies for hospital outpatient services and ambulatory surgical centers (ASCs) contained little to make hospitals optimistic about the government portion of their payer mix.  Base payments for items and services furnished in hospital outpatient settings and ASCs will increase by 3.1% after factoring in the usual…

Nick Hut December 12, 2023

RemitConnect® helps healthcare organizations automate manual posting and reconciliation processes

This HFMA Peer Review Spotlight explores the benefits of CommerceHealthcare's RemitConnect solution in complementing a healthcare organization's existing patient accounting or practice management system.

HFMA December 11, 2023

With a new rule, CMS looks to crack down on states’ Medicaid disenrollment processes

In its latest effort to stem the ongoing wave of Medicaid disenrollments, CMS issued regulations describing its authority to penalize states for disregarding federal guidelines pertaining to the end of continuous-enrollment requirements. Published Dec. 6 in an interim final rule with comment period, the regulations took effect immediately and were based on provisions passed by…

Nick Hut December 11, 2023

Key Senate committee takes a close look at healthcare waste and prices

The U.S. Senate is intent on finding ways to improve the value of healthcare, according to takeaways from a recent hearing of the Budget Committee. Although other committees and subcommittees in both chambers of Congress have held meaningful hearings about healthcare policy and costs this year, the Budget Committee’s attention to the matter is especially…

Nick Hut December 7, 2023

10 Keys to Restoring Trust in Healthcare

The issue of restoring consumer trust in the U.S. healthcare system encompasses a wide range of concerns. Factors in the perceived loss of trust include anxiety and confusion over costs, entrenched inequity, a glut of misinformation about vaccines and other treatments, and data and privacy breaches. To examine the problem and explore solutions, HFMA’s 16th…

Nick Hut December 7, 2023

HFMA Comments on Federal Independent Dispute Resolution Operations, Proposed Rule

HFMA presents its comment letter on CMS’ Federal Independent Dispute Resolution Operations Proposed Rule.

HFMA December 6, 2023

CY 2024 Physician Fee Schedule Final Rule Summary Part III – Quality Payment Program Updates

HFMA presents part III of three detailed summaries of the final rule relating to the Medicare physician fee schedule for CY 2024 and other revisions to Medicare Part B policies. Part III covers the updates to the Quality Payment Program.

HFMA December 4, 2023
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