News Briefs: Medicaid DSH payment cut barely averted in September, still possible in November
Hospitals received a last-day reprieve from substantial cuts to Medicaid disproportionate share hospital (DSH) payments, with House leaders reversing course Sept. 30 and ushering through a six-week government funding package. Language in the bill ensured the start of a four-year Medicaid DSH cut amounting to $32 billion was pushed back from Oct. 1 to Nov.…
HRSA curtails pandemic-era 340B flexibilities for hospitals’ off-campus outpatient facilities
In an expected move that stands to affect the savings reaped by health systems from the 340B Drug Pricing Program, the Health Resources and Services Administration (HRSA) is tightening participation requirements for off-campus outpatient facilities. In a published alert, HRSA announced plans to end pandemic-related flexibilities that have made it easier for off-campus outpatient facilities…
Dennis Dahlen: Are states losing patience with the pace of healthcare value transformation?
The pace of state-based regulation and oversight of healthcare providers is accelerating — and it could be an indication that patience is growing thin with federal, payer and provider efforts to improve healthcare value. Across the nation, we’re seeing a growing number of states adopt healthcare affordability boards. It’s a trend that started to pick…
Andrew Donahue: 4 reasons results of the 2024 election won’t matter for healthcare
There is a strange and underappreciated truth at the top of the American political system: Our president is remarkably powerless. Except in the realms of foreign policy, executive agency action and judicial branch appointments, the president’s policy agenda is rarely guided by intention. Rather, it is defined by limitation. Savvy presidents learn quickly that their…
The employer strikes back: The hollowing of the commercial health insurance market and its impact on payers and providers
Today, the commercial group health insurance market is hollowing out, primarily driven by affordability pressures that have been building for decades. Employers, unions, associations and other entities provided health insurance to nearly 180 million Americans in 2022, or 55% of the population, according to the U.S. Census Bureau, making commercial group health insurance a mainstay…
Healthcare News of Note: With new treatments emerging, Medicare increases coverage of PET screening for Alzheimer’s disease
Over the past few weeks, I have found these industry news stories that should be of interest to healthcare finance professionals. 1. CMS updates Medicare coverage of PET scans as a screening tool for Alzheimer’s disease CMS recently moved to expand Medicare coverage of screening for a primary marker of Alzheimer’s disease, a key step…
HFMA Comments on Federal Independent Dispute Resolution Process Fees Proposed Rule
HFMA presents its comment letter on CMS’ Federal Independent Dispute Resolution Process Fees Proposed Rule.
Hospital, physician advocates disagree over the role of physician-owned hospitals as policymakers ramp up focus
Hospital advocacy groups hope to stanch momentum that’s building in policy circles to increase the number of physician-owned hospitals. The American Hospital Association (AHA) and Federation of American Hospitals (FAH) issued a joint statement Oct. 18, saying permitting greater numbers of physician-owned hospitals (POHs) would have adverse effects on healthcare costs, access and quality. The…
CY 2024 Physician Fee Schedule Proposed Rule Summary Part III – Quality Payment Program Updates
HFMA presents part III of three detailed summaries of the proposed rule relating to the Medicare physician fee schedule for CY 2024 and other revisions to Medicare Part B policies. Part III covers the updates to the Quality Payment Program.
CY 2024 Physician Fee Schedule Proposed Rule Summary Part II – Medicare Shared Savings Program Requirements
HFMA presents part II of three detailed summaries of the proposed rule relating to the Medicare physician fee schedule for CY 2024 and other revisions to Medicare Part B policies. Part II includes proposals related to the Medicare Shared Savings Program.