Ahead of expected turmoil, the hospital sector is on solid footing
With uncertainty on the horizon for healthcare operations, hospitals and health systems appear to have established a stable foundation from which to respond to challenges. Recently reported financial data offers further indication that the not-for-profit (NFP) hospital sector has attained a measure of equilibrium several years after the pandemic and the ensuing turbulence in labor…
Finalized regulations look to phase out the manual aspect of prior authorization
Medicare’s FY26 final rule for hospital inpatient payments includes the latest federal effort to streamline and improve prior authorization. The rule has a subset of regulations titled “Health Data, Technology and Interoperability: Electronic Prescribing, Real-Time Prescription Benefit and Electronic Prior Authorization,” issued by HHS’s Assistant Secretary for Technology Policy and Office of the National Coordinator…
News Briefs: Budget reconciliation bill finalized with big implications for Medicaid
Declines in coverage and spending await the healthcare industry under the budget reconciliation bill signed into law by President Donald Trump on July 4. The Congressional Budget Office (CBO) projects $912 billion in reduced Medicaid spending and 10 million additional uninsured Americans in 2034 as a result of the law known as the One Big…
Soaring charity care grabs hospital leaders’ attention
Across the country, hospitals are reexamining their approach to uncompensated care, with first movers in this space increasing the availability of financial assistance and working harder to reduce the chances that an account will be sent to collections. And now, new data paints a picture of the collective impact of these efforts and other trends…
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…
Part A hospital spending is helping to accelerate Medicare insolvency, trustees say
The costs of hospital inpatient care are a key driver in forecasts that the Medicare Hospital Insurance (HI) Trust Fund will run out of money within eight years. As described in the latest annual report of the Medicare trustees, the projection of a 2033 insolvency date represents a three-year acceleration from last year’s estimate. Changes…
Why pending healthcare policies look so daunting for hospitals
For both revenue and costs, ongoing policy developments pose a risk of aggravating trends that already are constraining hospital budgets. The budget reconciliation bill in Congress and the imposition of extensive tariffs would add to ongoing pressures on hospital finances. Bad debt levels are rising among not-for-profit hospitals, as are supply costs, and those issues…
The financial cost of hospital and community violence
A new study assesses the financial impact of violence in hospitals and their communities, finding that the issue amounts to a multibillion-dollar problem annually. Estimated costs total $18.27 billion per year, according to a report published June 2 by the American Hospital Association (AHA). The largest share of that total, $13.1 billion, is the amount…