10 Vital Responses to Healthcare Disruption
Disruption is reverberating throughout the healthcare industry, and it’s incumbent on legacy organizations to develop strategic responses for the benefit of their consumers, their communities and themselves. With that overarching challenge becoming ever more pressing, HFMA’s 2023 Spring Thought Leadership Retreat brought together leaders from across the industry May 4-5 in Atlanta to consider approaches…
Billions of dollars in lump-sum payments are coming to hospitals as a remedy for 340B-related underpayments
Hospitals that participate in the 340B Drug Pricing Program stand to receive $9 billion in aggregate lump-sum payments as compensation for underpayments from Medicare during a nearly five-year period. In a proposed rule issued July 7, CMS described how it would provide remedies following a 2022 Supreme Court ruling that the U.S. Department of Health…
Annual Conference: For hospitals, effective chargemaster management can bolster revenue capture
Amid the changes and challenges buffeting the hospital and health system sector, chargemaster management remains a key step in protecting revenue, according to a presentation this week at HFMA’s Annual Conference. At University of New Mexico Hospital (UNMH), a recent chargemaster initiative began with a thorough review, said Holly Cruz, senior financial analyst with University…
Annual Conference: Health system CFO panel reflects on the importance of embracing change
The healthcare industry is enduring tough times, but finance leaders are equipped to guide their organizations through choppy waters, CFOs said Sunday as part of a panel discussion. Speaking onstage during the opening session of HFMA’s Annual Conference in Nashville, five health system CFOs described how they’ve responded during a tumultuous period that began more…
Denials Management Research Report
HFMA, with sponsorship from Waystar, surveyed 415 healthcare finance and revenue cycle executives to understand how denials are affecting their revenue cycle operations.
Survey reveals 5 opportunities to tackle denial prevention and management
In this survey, responses found when organizations devote greater resources to denial management than to denial prevention, their rate of first-pass denials is higher: 13.6% versus 10.9%.
MedPAC takes aim at the Medicare wage index and reiterates support for site-neutral payment
In its semiannual report to Congress, the Medicare Payment Advisory Commission (MedPAC) recommends significant changes to two key aspects of Medicare policy: the wage index and site-neutral payment. 1. A revamp of the wage index The wage index consistently generates concern among healthcare stakeholders, including in Medicare’s FY24 proposed rule for hospital inpatient payments. According…
HFMA Annual Conference preview: How Vanderbilt University Medical Center built a successful bundled payment program
Dr. Brittany Cunningham from Vanderbilt University Medical Center discusses her upcoming presentation at HFMA's Annual Conference in Nashville. Also in this episode, strategies for cash flow discrepancies with sponsor organization Inovalon.
Medicaid Drug Misclassification Proposed Rule Summary
The rule proposes to implement policies in the Medicaid Drug Rebate Program (MDRP) related to legislative requirements addressing drug misclassification, as well as drug pricing and product data misreporting by manufacturers.
As anticipated, the start of the Medicaid unwinding process has taken a toll on coverage
Fears among healthcare policymakers that the end of the COVID-19 public health emergency would sow chaos in Medicaid have been realized, leading the Biden administration to intensify its mitigation efforts. The end of Medicaid continuous-enrollment provisions is affecting the program in many states. In 21 states that had begun the “unwinding” process since April 1,…