Category: Healthcare Finance News

HIMSSCast: Embrace technology to replace the mundane tasks

Mike Alkire, president and CEO of Premier often advises health system executives. In fact, Alkire and the group purchasing organization advise an estimated 4,400 health systems and 250,000 providers in the United States.
“If I were running a healthcare…

HHS proposed rule targets ‘junk’ health insurance plans

Junk health plans are in the crosshairs of the Department of Health and Human Services, which pledged this week to protect consumers from such plans, as well as surprise medical bills and excess costs that lead to medical debt.

Aetna sued by Kraft Heinz for allegedly mishandling data

An employee benefits group at Kraft Heinz Co. has filed a lawsuit against insurer Aetna, accusing the company of breaching its fiduciary duties by leveraging its status as a third-party claims administrator to benefit itself financially.

Medicare Advantage quality bonus program failing to meet objectives, report finds

The Medicare Advantage quality bonus program, established by the Affordable Care Act as part of a package of MA reforms, was expected to reduce payments to MA organizations. But according to a new Urban Institute report, the expected cost savings from …

The transactional revenue cycle no longer works: Here’s what does

NASHVILLE – Transactional revenue cycle no longer works with patients, especially millennials, said finance experts speaking during the HFMA conference in Nashville.
It used to be, do the service and then bill, said Bob Stearns, director of Patient Acc…

U.S. News revises ‘Best Hospitals’ methodology in wake of backlash

Following backlash, U.S. News and World Report has made a number of changes to its methodology for its upcoming Best Hospitals rankings, which are due for release on August 1.
Officials from U.S. News, including Managing Editor and Chief of Health Anal…

AI’s automation can transform the revenue cycle 

NASHVILLE – Automation, particularly through AI, holds the promise of greater efficiency and fewer denials in the revenue cycle.
There’s $9.8 billion in potential savings through automation in the revenue cycle, according to statistics provided by TruB…

South Dakota expanding Medicaid to 52,000 residents

South Dakota has decided to expand Medicaid under the Affordable Care Act, and according to the Department of Health and Human Services, this will result in new eligibility for health coverage for about 52,000 residents of the state, including many mem…

Payers could see 7% spike in healthcare costs in 2024

Healthcare costs are expected to increase as much as 7% in 2024 due to continued labor shortages, drug price increases and new contracts between payers and providers – representing a larger jump in costs than in either of the previous two years.

Home Health payments proposed to decrease by 2.2%

Home Health Agencies get a 2.2% payment decrease compared to 2023, due in part to a permanent behavior assumption adjustment.