Hospitals push back on Senate report that calls out lack of spending on charity care
Not-for-profit (NFP) hospitals continue to be the subject of congressional scrutiny, with the chair of a key Senate committee issuing a report that questions whether they provide levels of charity care that are commensurate with their tax exemption. The report was released Oct. 10 by Senator Bernie Sanders (I-Vt.), chair of the Senate Health, Education,…
3 key interventions to address lagging payer reimbursements
It seems as if commercial payers are doing all they can to keep from reimbursing providers in a timely manner. According to a recent report by Crowe, 31% of claims submitted to commercial payers in the first quarter of 2023 were not paid for at least three months, as compared with 12% of Medicare claims.…
Applying AI to revenue cycle management
Three examples of AI applications in healthcare provide insight into how healthcare providers are using the technology today. The organizations are Auburn Community Hospital in Auburn, New York; Banner Health in Phoenix, Arizona; and Community Medical Centers, based in Fresno, California, Addressing RCM staffing shortages: Auburn Community Hospital Auburn Community Hospital, an independent 99-bed rural…
PFC USA’s partnership approach ensures healthcare clients tackle regulatory and patient satisfaction issues
Review some tips from a company with 6.5 years of hands-on experience in helping its healthcare clients handle concerns in healthcare such as workforce shortages and a volatile regulatory environment.
New approaches to nonclinical workforce management
Five healthcare leaders in revenue cycle management and patient access share their approach to workforce management in a remote and/or hybrid model and lessons learned along the way.
CMS pressures states to restore Medicaid coverage for some beneficiaries who have been disenrolled
CMS says a recent edict to state Medicaid programs has partially stanched the ongoing wave of disenrollments in the program, with about 500,000 beneficiaries set to regain coverage they had lost and “many” others protected from disenrollment going forward. As described in a Sept. 21 summary, 29 states plus Washington, D.C., have acknowledged a systemic…
HHS sets new administrative fee to be paid by parties in No Surprises Act independent dispute resolution cases
Oct. 6 update: The lead section of this article was updated where noted with news about the arbitration portal. The administrative fee for taking out-of-network payment disputes to arbitration under the No Surprises Act in 2024 would be significantly lower than it was for much of 2023, but triple the current rate, according to proposed…
Driving dollars through data: An innovative way to improve self-debt collections
Recent industry trends indicate the challenge of self-pay collections within the revenue cycle management (RCM) space will continue to rise, driven primarily by the increasing number of consumers opting for high deductible health plans. Effective collections strategies require additional expertise to focus efforts where there is a higher return on investment. It’s time-consuming to chase…
As clock ticks toward massive Medicaid disproportionate share hospital cuts, proposed bill would bring relief
A congressional bill that would impose additional transparency requirements on providers also would offer a respite from a sizable cut to a key supplemental payment. A $32 billion reduction to Medicaid disproportionate share hospital (DSH) payments is scheduled to span four years, beginning when federal FY24 gets underway Oct. 1. The Lower Costs, More Transparency…
Legislation to enhance healthcare pricing and billing transparency takes a big step forward in the House
A slew of provisions on healthcare transparency took a step closer to becoming federal law as three House committees last week merged separate bills into a single draft. The resulting bill is just about set for consideration by the full House, where bipartisan support for the major provisions was apparent in the committee phase. The…