Revenue Cycle Management Healthcare News

Public, not nonprofit hospitals use 340B to expand services

by

A new study published in JAMA Health Forum finds participation in the 340B Drug Pricing Program helps public but not nonprofit hospitals sustain unprofitable service lines, like psychiatric...

Pandemic volume changes underscore rural hospital concerns

by

A new study in Health Affairs finds that rural hospitals experienced more variability in patient volume during the first two years of the COVID-19 pandemic than their urban counterparts. However, these...

Medicare funds slated to run out by 2036 without changes

by

Medicare money will dry up in a little over a decade, according to the latest the federal program’s trustees. The trustees’ annual report to Congress estimates that Medicare’s...

New AHA report paints dire financial picture for hospitals

by

Hospitals are in a precarious financial position, according to a new report from the American Hospital Association (AHA). Hospitals and health systems are up against persistently high expenses for...

Hospital profitability dips as expenses bog down margins

by

Hospital profitability has hit a snag after a relatively strong first quarter, according to the latest data from healthcare consulting firm Kaufman Hall. The April 2024 “National Hospital Flash...

Machine learning algorithm improved risk adjustment models, study finds

by

A Diagnostic Cost Group (DCG) machine learning algorithm succeeded in generating risk adjustment models and predicted healthcare spending better than the current HHS hierarchical condition category...

Market consolidation worse among payers than health systems

by

There has been a large focus on how market consolidation among hospitals and health systems, including physician practice acquisitions, affects competition, pricing, and access to care. However, new...

Breaking down the new CMS proposed bundled payment model: TEAM

by

CMS has proposed a new mandatory bundled payment model to test if episode-based payments for select surgical procedures would lower Medicare spending and improve care quality. The Transforming Episode...

Study: Lax antitrust enforcement boosting hospital prices

by

A recent study in the journal American Economic Review: Insights found that lax antitrust enforcement contributed to less competition and higher prices for hospital care. The study, conducted by...

CMS sets minimum staffing standards for nursing homes

by

A new final rule from CMS establishes minimum staffing standards for nursing homes at a national level for the first time in history. The rule states that nursing homes participating in Medicare and...

Portal allows public reporting of anti-competitive behaviors

by

A new online portal allows the public to report any anti-competitive behaviors they see in the healthcare sector that may be impacting quality of care and affordability. The Federal Trade Commission...

HHS finalizes 340B Administrative Dispute Resolution process

by

A new rule from HHS finalizes a revised Administrative Dispute Resolution (ADR) process under the 340B Drug Pricing Program (340B), which will allow covered entities to address disputes with...

Half of private equity-owned physician practices are resold within 3 years

by

More than half of private equity-acquired physician practices underwent an exit within three years of acquisition, with most practices being resold to other private equity firms, according to a study...

About 1 in 5 healthcare bankruptcies in 2023 owned by PE firms

by

A new report reveals a record year for healthcare bankruptcies as more private equity-owned companies filed for bankruptcy in 2023. There were approximately 80 healthcare bankruptcies last year,...

Hospital merger and acquisition activity generated $12B in Q1 2024

by

Hospital merger and acquisition activity in quarter one of 2024 hit a first-quarter high since 2020, with 20 announced transactions generating $12 billion, a Kaufman Hall report found. The number of...

Nearly 4 of 5 physicians employed by hospitals, corporations

by

Widespread consolidation in healthcare is affecting physicians, according to a new report from the Physicians Advocacy Institute (PAI) and Avalere Health. The report analyzed updated data from IQVIA...

AMA, NAACOS, AHIP share how to succeed in value-based care arrangements

by

The American Medical Association (AMA), the National Association of Accountable Care Organizations (NAACOS), and AHIP have released a playbook on value-based care best practices, highlighting the...