Pharmacy transparency: a rising trend in the industry
After publishing my Nov. 29 blog, which delved into Cost Plus Drugs’ expansion into the specialty drug market, CVS Health revealed plans to streamline its pricing and sales approach for pharmaceuticals in retail pharmacies. This move by the pharmacy giant, which operates approximately 9,500 retail pharmacies, involves simplifying the reimbursement process for these pharmacies. The…
10 Keys to Restoring Trust in Healthcare
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, a glut of misinformation about vaccines and other treatments, and data and privacy breaches. To examine the problem and explore solutions, HFMA’s 16th…
Prior authorization in Medicare Advantage remains in the policy spotlight as 2024 regulations take effect
Healthcare policymakers and stakeholders continue to mull the need for guardrails to ensure optimal customer service among Medicare Advantage (MA) health plans. The American Hospital Association wrote a Nov. 20 letter to CMS stating that MA plans are looking to skirt policies designed to ensure straightforward coverage of essential healthcare services. These policies, finalized earlier…
2024 Health System Digital & IT Investments
This survey of 144 provider executives reveals their top digital and IT investment priorities for 2024 and associated challenges, opportunities, and goals.
Congress doesn’t seem to be mulling a fix for the 2024 Medicare physician payment cut
Congress has mitigated a scheduled Medicare payment cut for physicians going into each of the last three years, but relief does not appear to be on the way for a fourth year running. Medicare’s 2024 final rule for physician payments includes a $1.15 decrease to the conversion factor, amounting to a reduction of more than…
Proposed rule sets Medicare penalties for providers that commit information-blocking infractions
Hospitals and other healthcare providers would face penalties for knowingly engaging in information blocking, with the sanctions affecting their Medicare reimbursement, according to a proposed rule from the U.S. Department of Health and Human Services (HHS) and CMS. Published at the beginning of November, the rule implements some terms of the 21st Century Cures Act,…
Research Summary: 2024 Digital & IT Investment Trends
HFMA, with sponsorship from Guidehouse, surveyed 144 healthcare executives to understand their digital and IT investment priorities going into 2024. The survey found that 85% expected their organization’s digital and technology budget to increase in 2024. The top three priorities for investment included: cybersecurity infrastructure, EHR integration and modernization, and digital front door or virtual…
Leveraging investments to strengthen resilience: Key insights
The approach health systems take to balance sheet and treasury management varies significantly. One company's managing director dives into how organizations can take a balanced-scorecard method to investments using a tier system.
The No Surprises Act: How healthcare organizations can create a winning strategy
Find a breakdown of the No Surprises Act in this business profile with an update on four main administrative requirements of the bill and insight to improve hospitals and healthcare systems using technology for future regulatory changes.
Humans are essential to your AI strategy
Arun Shastri of ZS discusses uses for AI in healthcare as well as the limitations of technology when a human isn't involved.