Report quantifies the financial impact of certain health plan business practices on providers
As hospitals seek to regain their financial footing coming out of the pandemic, they may find themselves stymied by commercial payer policies, according to a new report. “It’s true that commercial payers might generate more net revenue than public payers on a per-case basis,” Crowe states in a report it recently published. “But at what…
Case Study: Dartmouth Health Achieves 101.6% of Cash Collection Goal Over 8-Year Partnership
Monthly reconciliation within the large healthcare system had become unpleasantly burdensome. With over 250 systems and practices, the healthcare company needed a platform that would support growth, manage multiple payments types and reconcile to more than one bank, while maintaining a single source of truth for audit and compliance. This case study presents challenges Dartmouth…
New data on No Surprises Act arbitration cases show providers are faring well amid systemic challenges
Providers are having success at challenging out-of-network payment amounts under the No Surprises Act, at least when they can get their cases through the arbitration system. CMS published an update showing that between April 15, 2022, when the independent dispute resolution (IDR) portal opened, and March 31, arbitrators issued payment determinations in 42,158 disputes. Initiating…
5 issues that are keeping healthcare compliance professionals up at night
Rarely has the compliance landscape been more muddled or presented more of a challenge for healthcare organizations. “I’ve been a compliance officer for about 20 years now, and I’ve been in healthcare forever,” said Kirsten Wild, RN, a nurse by background who now owns a healthcare compliance consultancy. “But the volume and the pace of…
Gail Wilensky: No Surprises Act — where things stand after 16 months
Few areas of concern within our nation’s healthcare system have caused patients, their families and caregivers more consternation than surprise medical bills. Most of the new protections under the 2020 No Surprises Act became effective on Jan. 1, 2022. Last August, the Departments of Labor, Health and Human Services and Treasury released a statement providing…
Healthcare Blame Game, the podcast: First episode is here!
The much-anticipated pilot episode of the “Healthcare Blame Game” podcast is now live and available to HFMA members. In this episode, HFMA Chief Content Executive Brad Dennison and Executive Producer Erika Grotto question the methodology and narrative of a recent Kaiser Health News investigation.
Healthcare Blame Game: How news outlets mishandled a medical debt study
Brad Dennison is a 25-year veteran of the newspaper industry. He served 15 years as the top news executive for multiple national organizations and led thousands of journalists across the U.S., including investigative teams. He’s also a past board member of the Associated Press Media Editors, where he was elected national chair. Dennison joined HFMA…
Automation from documentation capture to code: Insights from healthcare finance leaders
Read tips on strengthening return on investment and engagement as well as the role of process automation in navigating the documentation and workforce challenges facing healthcare in this roundtable with hospital leaders.
New guidance for No Surprises Act arbitration looks like an improvement for providers
Responding to a recent court ruling, the U.S. Department of Health and Human Services (HHS) has updated the application of criteria for deciding No Surprises Act (NSA) independent dispute resolution (IDR) cases. Certified IDR entities (i.e., arbitrators) received guidance March 17 instructing them to more directly consider multiple factors when deciding on an out-of-network payment…
Healthcare Blame Game: How Kaiser Health News mistook policy for practice in hospital collections report
Brad Dennison is a 25-year veteran of the newspaper industry. He served 15 years as the top news executive for multiple national organizations and led thousands of journalists across the U.S., including investigative teams. He’s also a past board member of the Associated Press Media Editors, where he was elected national chair. Dennison joined HFMA…