Payment Trends

For providers, application of the 2-midnight rule to Medicare Advantage appears to bring a revenue influx

Hospitals appear to have gained a significant, albeit likely short-term, revenue boost from CMS’s 2023 directive to Medicare Advantage (MA) health plans regarding the two-midnight rule. The rule first was instituted in 2013 for Medicare fee-for-service (FFS), requiring the program to cover hospital stays as inpatient admissions if the admitting physician expects the stay to…

Nick Hut June 3, 2024

David Johnson: Site-neutral payment and the battle for healthcare’s soul

In  a remarkable and surprising show of bipartisanship, the U.S. House of Representatives passed the Lower Costs, More Transparency Act on Dec. 11, 2023, by an overwhelming 320-71 vote. Avoiding hyperbole, the act lives up to its name. It seeks to equalize Medicare payment for the same drugs administered in the same way, whether in…

David W. Johnson May 22, 2024

Closures of Walmart’s health centers reflect the widespread financial constraints in U.S. healthcare

Beyond signaling a setback for retail-based healthcare disruptors, Walmart’s recent decision to close its health centers is symptomatic of issues hampering the nation’s ecosystem for primary care, industry analysts say. The retail behemoth announced April 30 it would be closing all 51 of its health centers across five states, along with its virtual-health service. Five…

Nick Hut May 7, 2024

Navigating toward successful contract negotiations with health plans

A group of healthcare leaders discuss various tactics they are using to negotiate better rates with payers and ensure payers’ commitment to accurate, timely payment.

HFMA May 1, 2024

Improve Patient Refunds With A Simplified B2C Payments Solution

Download this eBook to get insights into patient refunds and a solution to streamline the process for the provider while improving the patient financial experience.

HFMA March 20, 2024

Continued 340B eligibility is at risk for hundreds of hospitals thanks to pandemic-related factors

Hospitals that rely on savings from the 340B Drug Pricing Program should examine the possibility that they will soon be rendered ineligible. Several factors are having an industrywide impact on the disproportionate share hospital adjustment percentage, and if that tally drops below a certain threshold on a hospital’s Medicare cost report, the hospital cannot receive…

Nick Hut March 1, 2024

The importance of digital transformation in a fraudulent environment

In this recently conducted survey, more than 85% of responding hospital financial executives said they are somewhat concerned (65.96%) or very concerned (19.15%) about potential AI-influenced fraud, including account takeovers and eventually payment fraud.

HFMA February 29, 2024

How digital patient engagement solutions can help healthcare organizations improve their existing revenue cycle

This roundtable features various healthcare professionals who breakdown what digital patient engagement solutions are being implemented and how this not only empowers patients, but also helps organizations looking to improve their existing revenue cycle.

HFMA February 29, 2024

Healthcare Finance Trends for 2024

Download this eBook to see details of the 10 financial trends that will shape 2024 for hospitals and health systems across the country.

HFMA February 28, 2024

Hospitals say Supreme Court should hear a case that affects disproportionate share hospital payments

Hospital advocacy groups hope the Supreme Court will review a lower-court ruling that has adverse implications for Medicare disproportionate share hospital (DSH) payments. Six groups on Feb. 2 submitted an amicus brief to the Supreme Court regarding an appeals court’s 2023 decision backing HHS’s interpretation of the DSH payment formula. The department long has said…

Nick Hut February 5, 2024
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