CMS looks to modernize the U.S. digital health infrastructure
Eight health systems have joined a Trump administration initiative to accelerate the implementation of integrated patient-facing technology in the healthcare ecosystem. The agreement is a voluntary pledge by the health systems to be early adopters of forthcoming technology that will be designed, in part, to enhance interoperability and eliminate paper-based clinical encounters. Participants will be…
People: HFMA members step into new CFO roles
Jessica Graham is serving as CFO of Banner – University Medical Center Tucson Banner – University Medical Center Tucson appointed Jessica Graham, MBA, as CFO in May. Graham’s previous appointments include more than six years with Houston-based Memorial Hermann Health System and a 10-month stint as interim vice president and chief business officer with University…
Reeling payers plan to increase scrutiny of providers’ coding practices
Health insurers see provider coding practices as one factor in unfavorable cost trends, several companies said during recent earnings calls. Those cost trends, in turn, have driven substandard Q2 financial results. “We know this adjustment is disappointing, and we’re taking concrete actions to address it,” Gail Boudreaux, president and CEO of Elevance Health said recently,…
In comments, for-profit hospital leaders don’t dwell on ‘Big Beautiful Bill’ impact
Leaders of for-profit hospital chains ranged from noncommittal to confident in recent remarks about impending rollbacks to Medicaid and the Affordable Care Act (ACA). Hospitals have several years to prepare for some of the changes, and the interval also leaves time to modify policies in the newly passed budget reconciliation bill, health system leaders said…
Perils and promise of Medicare Advantage highlighted at congressional hearing
Testimony during a congressional hearing this week highlighted the strain hospitals are experiencing from the administrative roadblocks posed by Medicare Advantage (MA). For all the potential seen in the program to improve health and care delivery, MA is not working the way it should, several industry experts acknowledged during the July 22 joint hearing of…
The latest on providers’ landmark antitrust suit alleging price fixing by MultiPlan and healthcare insurers
Billions of dollars are at issue in an ongoing lawsuit in which providers allege price fixing by a vendor and a large segment of the health insurance industry. Providers bringing the suit maintain that the healthcare technology solutions company MultiPlan and roughly 700 health plans conspired to suppress reimbursement for out-of-network services over a decade…
In Medicare’s latest hospital-focused rule, CMS pushes new proposals for price and quality transparency
Medicare’s 2026 proposed rule for hospital outpatient care includes the Trump administration’s latest effort to augment price transparency requirements. Two months after updated guidance featured a mandate to immediately start posting actual prices rather than estimates in machine-readable files (MRFs), among other directives, the proposed rule contains further steps in the name of specificity. The…
Proposed Medicare hospital payment rule includes a surprising cut
Although payment rates technically would increase under Medicare’s 2026 proposed rule for hospital outpatient care, various provisions would chip away at the finances of hospitals and health systems. Specifically, key provisions would equalize certain site-based payments and also accelerate a planned across-the-board payment decrease related to 2022 remedy payments that were made to 340B Drug…
In proposed Medicare physician payment rule, CMS emphasizes Trump administration priorities
Medicare’s 2026 proposed rule for physicians is a key early chance for the Trump administration to shape U.S. healthcare policy in alignment with HHS Secretary Robert F. Kennedy Jr.’s Make America Healthy Again approach. Some of the most noteworthy provisions thus represent an effort to shift resources to primary care and prevention and to crack…
Constriction looms for a key segment of healthcare coverage
The reverberations for Medicaid have drawn most of the recent headlines, but federal policy developments also portend a big contraction of the individual-insurance market in 2026 and beyond. Although group coverage remains the predominant form in the U.S., the market for individual plans has been growing amid recent surges in Affordable Care Act (ACA) enrollment.…