The employer strikes back: The hollowing of the commercial health insurance market and its impact on payers and providers
Today, the commercial group health insurance market is hollowing out, primarily driven by affordability pressures that have been building for decades. Employers, unions, associations and other entities provided health insurance to nearly 180 million Americans in 2022, or 55% of the population, according to the U.S. Census Bureau, making commercial group health insurance a mainstay…
Healthcare News of Note: With new treatments emerging, Medicare increases coverage of PET screening for Alzheimer’s disease
Over the past few weeks, I have found these industry news stories that should be of interest to healthcare finance professionals. 1. CMS updates Medicare coverage of PET scans as a screening tool for Alzheimer’s disease CMS recently moved to expand Medicare coverage of screening for a primary marker of Alzheimer’s disease, a key step…
HFMA Comments on Federal Independent Dispute Resolution Process Fees Proposed Rule
HFMA presents its comment letter on CMS’ Federal Independent Dispute Resolution Process Fees Proposed Rule.
Hospital, physician advocates disagree over the role of physician-owned hospitals as policymakers ramp up focus
Hospital advocacy groups hope to stanch momentum that’s building in policy circles to increase the number of physician-owned hospitals. The American Hospital Association (AHA) and Federation of American Hospitals (FAH) issued a joint statement Oct. 18, saying permitting greater numbers of physician-owned hospitals (POHs) would have adverse effects on healthcare costs, access and quality. The…
CY 2024 Physician Fee Schedule Proposed Rule Summary Part III – Quality Payment Program Updates
HFMA presents part III of three detailed summaries of the proposed 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.
CY 2024 Physician Fee Schedule Proposed Rule Summary Part II – Medicare Shared Savings Program Requirements
HFMA presents part II of three detailed summaries of the proposed rule relating to the Medicare physician fee schedule for CY 2024 and other revisions to Medicare Part B policies. Part II includes proposals related to the Medicare Shared Savings Program.
In response to a congressional RFI, provider advocates give input on ways to bolster rural healthcare
Hospital and physician groups were among the respondents to a request by a key congressional committee for information on improving rural healthcare. In an RFI issued in September, the House Ways and Means Committee sought policy solutions for augmenting access to — and the quality of — healthcare in relatively remote areas. “The committee will…
CY 2024 Physician Fee Schedule Proposed Rule Summary – Part I
HFMA presents part I of three detailed summaries of the proposed rule relating to the Medicare physician fee schedule for CY 2024 and other revisions to Medicare Part B policies.
HHS: Insurers won’t be penalized if they don’t update their No Surprises Act qualifying payment amounts as required
Providers may not immediately benefit from a favorable court ruling that affects the methodology for determining the qualifying payment amount (QPA) under the No Surprises Act. The U.S. Department of Health and Human Services (HHS) issued guidance Oct. 6 that says the Biden administration will not enforce the court decision until at least May 1.…
Insights on population health management challenges through the eyes of C-suite leaders
Population health management is at a crossroads, and one key to ensuring its viability is to bolster stakeholder trust in the potential of value-based payment (VBP) models. That was a key takeaway from healthcare executives who took part in a September panel discussion at the 23rd annual Population Health Colloquium, hosted by the Jefferson College…