Dr. Oz describes a reimagined, technology-driven healthcare ecosystem
A rapid acceleration of digital healthcare applications and a sharpened focus on fraud, waste and abuse will be central to the looming transformation of the U.S. healthcare system, Mehmet Oz, MD, administrator of CMS, told a healthcare audience Wednesday. Oz spoke May 21 in Manhattan at the Not-for-Profit Healthcare Investor Conference, sponsored by HFMA, Barclays…
Achieving “smart scale”: Insights from today’s high-performing health systems
Senior healthcare leaders and board members routinely ask us the following two questions: In our experience, exploring the answers to these questions can lead organizations down a variety of strategic paths, and most organizations have not yet developed a clear perspective on how they intend to make the most of greater scale. Our view is…
Court rules against drug companies on the question of a 340B rebate model
Hospitals hoping to avoid having to use a rebate model in the 340B Drug Pricing Program received good news in court recently. A federal judge issued a May 15 written opinion that the Health Resources and Services Administration (HRSA) was within its rights to deny four drug manufacturers unilateral authority to implement a rebate model…
Budget reconciliation bill faces a rocky road as Medicaid and ACA cuts draw provider concerns
In the days after a key House committee approved legislation that includes substantial cuts to Medicaid funding, the bill’s path forward remained full of obstacles. The healthcare portion of the budget reconciliation bill passed the Energy and Commerce Committee on a party-line 30-24 vote May 14. Since then, reports from Capitol Hill have detailed the…
The Healthcare CFO of the Future: Turning risk into opportunity
The role of the healthcare CFO is evolving — and so are the skills needed for success. Here, CFOs and industry experts explore the new competencies CFOs must possess and how leaders in this space are preparing for the future.
RFK Jr. defends HHS budget to Congress and talks Medicaid, 340B and more
In congressional testimony, HHS Secretary Robert F. Kennedy Jr. endorsed proposed Medicaid cuts as affecting fraud, waste and abuse rather than beneficiaries who most need the program. Speaking May 14 before a House Appropriations subcommittee and later the Senate Health, Education, Labor and Pensions (HELP) Committee, Kennedy also indicated a willingness to pare down the…
Medicaid provider payments take a hit in budget reconciliation bill
As released over the weekend, formalized plans to reduce federal Medicaid spending would have an impact on future state-directed supplemental payments and other aspects of the program. The House Energy and Commerce (E&C) Committee published its portion of a budget reconciliation bill that would slash 10-year projected federal spending. As expected, Medicaid would incur the…
Providers, payers both struggle with Medicare Advantage challenges
Note: This article was updated May 13 where noted. Neither providers nor a leading payer are finding much reason for satisfaction with the state of Medicare Advantage (MA) these days. Q1 financial reporting by for-profit hospital chains and by UnitedHealth Group (UHG), among other payers, have reflected the challenging landscape. UHG in April shared what…
Hospitals grapple with uncertain tariff fallout as pharmaceutical levy looms
May 28 update: A U.S. trade court has issued an injunction on most of the tariffs imposed by the Trump administration, although tariffs on individual products (e.g., steel and aluminum) can remain. The administration has appealed the decision. May 29 update: The tariffs are back on for now after an appeals court stayed the lower…
Fortifying revenue management: The critical role of health information management in cybersecurity preparedness
A hospital’s health information management (HIM) team oversees the flow of patient care documentation in healthcare organizations, supporting accuracy, accessibility and security. In the revenue cycle, HIM maintains financial integrity by managing patient data, ensuring proper coding and documentation for billing and verifying clinical data for compliance and reimbursement. HIM also plays an active role…