Hospitals reached steadier ground financially as they moved into 2024
Hospitals came into 2024 with some financial momentum, even as expenses continued to rise and pivotal decisions loomed. The year-to-date median hospital operating margin reached 2.3% in December, the high mark for 2023 and the 10th consecutive month in which margins were positive, according to monthly data from Syntellis Performance Solutions, part of Strata Decision…
Strategies for success: Tackling common clinical documentation integrity challenges head-on
Clinical documentation, which includes a record of exams, symptoms, diagnoses, medications, tests, treatments and other elements of a patient’s medical care, plays a vital role in creating a complete picture of an individual’s health and is needed to develop effective care plans. It also ensures that all providers who see the patient have access to…
CMS’s 2025 advance rate notice for Medicare Advantage brings potential concern for providers
Medicare Advantage (MA) health plans are projected to reap a 3.7% revenue increase in 2025, but provider payments could be affected by a decrease in plan benchmarks, per data shared in CMS’s annual advance notice. If finalized, the estimated 0.16% average reduction in base payments to plans could have consequences for care delivery, one provider…
Healthcare Blame Game: Patient Rights Advocate’s distortion of price transparency regulations and data, and the ad campaign that’s catching attention
Patient Rights Advocate (PRA) has engaged hip hop artists like Fat Joe, Busta Rhymes and Method Man in its “Power to the Patients” campaign, claiming that regulations around price transparency are not being enforced, allowing hospitals to hide their prices and “charge whatever they want.” On this episode, HFMA Policy Director Shawn Stack and Ruth Lande, vice president of hospital relations at RIP Medical Debt, discuss PRA’s misinterpretation of price transparency regulations and hospital pricing.
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’ll soon be rendered ineligible. Several factors are having an industrywide impact on the disproportionate share hospital (DSH) adjustment percentage, and if that tally drops below a certain threshold on a hospital’s Medicare cost report, the hospital cannot receive…
10 keys to restoring trust in healthcare: a summary
Note: This article was adapted from a report on HFMA’s 2023 Fall Thought Leadership Retreat. The full report is available for downloading. The issue of restoring consumer trust in the U.S. healthcare system encompasses a wide range of concerns. Factors in the perceived loss of trust include anxiety and confusion over costs, entrenched inequity, misinformation…
How healthcare finance organizations are working to become more resilient
Seven healthcare financial executives share their strategies for tackling the challenges of financial management in the current environment in this roundtable.
News Briefs: A new fee is set for using the No Surprises Act arbitration portal
Bringing out-of-network payment disputes to arbitration under the No Surprises Act in 2024 will be less expensive than previously proposed. In a final rule, the U.S. Departments of Health and Human Services, Labor and Treasury established the administrative fee for using the independent dispute resolution (IDR) portal at $115 per case, effective Jan. 22. That’s…
5 reasons to apply for a prestigious MAP Award for revenue cycle performance
For more than a decade, HFMA’s MAP Award for High Performance in Revenue Cycle has become the highest honor in the healthcare industry for revenue cycle excellence. If that’s not enough of a reason to apply for the chance at these accolades, here are five reasons why past winners apply year after year. 1. Bragging…
Medicare beneficiaries would have new options for appealing their hospital patient status under a proposed rule from CMS
A proposed rule from CMS would affect the appeals process for some patients whose status is reclassified from inpatient to outpatient observation during a hospital stay. After a 2020 court ruling that was upheld at the appellate level in 2022, the U.S. Department of Health and Human Services and CMS were obligated to create additional…