Changes to reimbursement for 340B drugs reverberate in the 2023 final rule for Medicare outpatient payments
The Medicare payment rate for hospital outpatient services will increase significantly in 2023, but the net gain will be quite a bit less than is apparent at first glance.
What healthcare system leaders say about the value-based care journey
In this roundtable, executives for health plans and health systems share challenges in value-based care and the significance of moving away from fee-for-service toward value-based-care.
Payment Reimbursement and Managed Care
News Briefs: Hospital labor costs rose by almost 40% between 2019 and early 2022
As published in hfm magazine, a monthly roundup of top news for healthcare finance professionals.
Medicaid expansion doesn’t appear to bolster finances or operations at critical access hospitals, study finds
Changes in operating margin, staffing ratios and quality metrics didn’t hinge on whether a critical access hospital was in a state that had expanded Medicaid.
Payment approaches to addressing health equity are seen in a new Medicare rule for kidney care
Updates to a Center for Medicare & Medicaid Innovation care model for end-stage renal disease include an equity-related bonus payment and associated changes to benchmarking.
Hospitals and Congress propose improvements to prior authorization processes in Medicare Advantage
The American Hospital Association says pending regulations that would affect prior authorization should be expanded to include Medicare Advantage.
Hospital groups express concern over earlier court ruling that could expand False Claims Act liability
The groups argue that allowing FCA claims to be brought for post-termination actions would defy congressional intent and leave hospitals subject to excessive financial liability.
Healthcare News of Note: Average billed charge for complex COVID-19 hospitalizations is more than three times the allowed amount
Report by Medicare trustees describes a daunting payment picture for healthcare providers
The Medicare Hospital Insurance Trust Fund is on course to run out of money by 2026, and that assessment wasn’t the only concerning part for hospitals in a new government report.