Medicare financial support for low-wage hospitals hits another roadblock in the courts
Plaintiff hospitals won a second consecutive appeals-court victory in the legal fight over Medicare’s low-wage-index policy. In December, the U.S. Court of Appeals for the Ninth Circuit upheld a district court’s ruling that the policy of increasing wage-index values for rural hospitals starting in 2020 was impermissible under the Medicare statute. The decision echoed a…
In surprise move, Biden administration terminates the Medicare Advantage Value-Based Insurance Design Model
A nearly decade-long effort to promote value-based insurance design (VBID) in Medicare Advantage (MA) will be discontinued after 2025, the Biden administration announced in December. The MA VBID Model has aimed to use health plan benefits design to encourage healthy behaviors and promote whole-person health among segments of beneficiaries. It began in 2017 and, after…
How regulatory shifts are shaping the future of revenue cycle operations
The healthcare industry is set for a major transformation, driven by government policies, legislative reforms, insurance updates and a continuous evolution of compliance and privacy standards that impact revenue cycle management (RCM). These developments present both challenges and opportunities for RCM teams but embracing them is crucial for healthcare organizations to thrive. Key regulatory changes…
Amid tight margins, MedPAC seems set to recommend an additional hospital payment boost
Hospitals have improved financially in the latest reporting period but still should receive a supplementary Medicare payment increase, according to a meeting of the Medicare Payment Advisory Commission (MedPAC). For 2026, Congress should authorize a 1% increase beyond the amount calculated using the statutory methodology, commissioners said during a December discussion. The notion is likely…
Final rules to support interoperability among healthcare stakeholders leave out key proposals
New regulations implemented by the Biden administration in December are designed to ease information-blocking compliance considerations for providers. Nonetheless, providers may be disappointed that technical provisions related to interoperability did not carry over from a wide-ranging proposed rule to a pair of streamlined final rules. Most notably, the finalized regulations exclude certification standards for application…
As data show a spike in spending on hospital services, new report lays out savings options
Accelerating hospital-focused expenditures helped spur a 2023 increase in national health spending, according to newly released data. Spending on hospital services surged by 10.4% for the year, up from a 3.2% increase in 2022 and 3.4% for the three-year period spanning 2020-22. The 2023 increase was the biggest seen since a 10.8% jump in 1990.…
Final bill ensures no loss of funding for Medicaid DSH payments, graduate medical education
The finalized continuing resolution (CR) to keep the federal government funded through mid-March includes key healthcare provisions. The bill that passed both chambers of Congress just before Friday night’s expiration of funding contained the same healthcare items as the version that failed to pass the House the day before. A key difference was the absence…
Which healthcare policies were kept in a doomed second version of the continuing resolution?
A slimmed-down version of a year-end government funding package retained some of the core healthcare provisions from a larger previous version, but little was certain after the second version failed to pass the House of Representatives. After President-elect Donald Trump spoke out against a bipartisan agreement Wednesday night, Republicans in the House drafted a streamlined…
Year-end spending legislation looks promising for healthcare stakeholders — if it passes
Advocates for hospitals and other healthcare providers generally commended an end-of-the-year federal spending package that includes most of their requested provisions. However, a specific item loomed as a source of concern in the hospital sector, and by early Wednesday evening, there were questions about the viability of the entire bill. Congress released text for a…
9 features of a revitalized healthcare workforce
As the 2030s approach, the horizon looks daunting for the healthcare workforce. Consider these trends: The entire baby boomer generation will be eligible for Medicare coverage by the turn of the decade. Clinician shortages are projected to be well into the six figures by 2034, accelerated by a reported exodus of 145,000 clinicians in 2021…