Finance and Business Strategy

Amid the challenges of the present moment, it may seem hard to find reason for optimism. But some metrics and trends represent a solid foundation on which not-for-profit hospitals and health systems can brace themselves against the headwinds. “Of the key tenets we look for in the sector, volumes are back to pre-pandemic levels and…

In potentially a rare dose of good news for providers about prior authorization, the health insurance industry has volunteered to scale back the process and introduce new accommodations, according to an announcement Monday. As described by the insurance lobby and the Trump administration, which convened a meeting Monday at which a large segment of the…

In April 1999, “The Modern Library” published its list of the top one hundred nonfiction books of the 20th century. Number one was “The Education of Henry Adams,” an intellectual autobiography written in 1905 by the great grandson and grandson of John Adams and John Quincy Adams, respectively, the second and sixth presidents of the…

Moves by the Trump administration to reduce HHS’s discretionary budget by 26.2% could have unintended adverse consequences. They not only could undermine the nation’s standing in the field of medical research, but also could derail progress in human health advances, promising medical findings and public health preparedness. Cuts to discretionary spending by the National Institutes…

For many health systems, utilization management (UM) has long been a functional necessity, but rarely a strategic priority. Originally designed to ensure clinical appropriateness and support payer requirements, UM often grew up within hospital walls, shaped by local workflows and embedded within broader care management structures. As a result, traditional UM functions today are frequently…

In traditional revenue cycle structures, managers move up the hierarchy because they are good at getting work done and solving problems. However, a successful continuous improvement culture needs not only effective managers but also empowered front-line staff who can share their insights and expertise. With this premise in mind, leaders at Mass General Brigham (MGB)…

Download this white paper to explore how leading health systems and ambulatory organizations leverage an overlooked opportunity to improve financial performance: automating payment posting and reconciliation.

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…

A rapid acceleration of digital healthcare applications will be central to the looming transformation of the U.S. healthcare system, according to Mehmet Oz, MD, administrator of CMS. Oz spoke at the annual Not-for Profit Healthcare Investor Conference, sponsored by HFMA, Barclays and the American Hospital Association. He sought to explain why sweeping, systemic changes are…

Danelle Newman from OSS Health discusses how to strike a balance in vendor and staffing management. Also in this episode, HFMA Senior Editor Rich Daly talks with HFMA Policy Director Shawn Stack about the House-passed reconciliation package.