Healthcare Spending

Why keeping private practices independent is vital

April 8, 2024 - What happens when one of the market’s most prominent players comes knocking at your practice’s door? For many physicians in private practices, it means merging with the hospital or health system, whether to stay competitive in the market, access resources from a larger organization, or keep the lights on in the face of persistent financial troubles. For others, though,...

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CMS releases tool to help hospitals with price transparency

by Jacqueline LaPointe

CMS recently released a web-based validation tool that assists hospitals with price transparency compliance. The updated V2.0 Online Validator Tool helps hospitals develop machine-readable files to...

Hospital payment cap slashes prices in Ore.

by Jacqueline LaPointe

An effort to reduce healthcare spending in Oregon has successfully lowered hospital prices and variation, according to a recent study in Health Affairs. Oregon implemented a cap on hospital prices in...

Little progress made with hospital price transparency compliance

by Jacqueline LaPointe

Hospitals have made little progress with implementing federal price transparency requirements that took effect in 2021. The latest semi-annual “Hospital Price Transparency Report” from...

Lower reimbursement rates, denials behind razor-thin margins

by Jacqueline LaPointe

Hospitals and health systems are operating on razor-thin margins as reimbursement rates and denials create financial woes, a new survey indicates. The survey conducted by the Healthcare Financial...

$460B spending bill averts shutdown, some physician pay cuts

by Jacqueline LaPointe

Congress narrowly avoided a partial government shutdown, sending a $460 billion spending bill to the President’s desk over the weekend. The bipartisan deal, passed by the House 339-85 last...

Trauma center hospitals charged above-market prices for non-trauma care

by Victoria Bailey

Hospitals designated as trauma centers charged higher prices for non-trauma inpatient admissions and emergency department visits compared to non-trauma center hospitals, a Health Affairs study...

Non-Profit Health Systems Need Positive Margins

by Jacqueline LaPointe

Non-profit health systems receive a lot of scrutiny because of their tax status, with some critics accusing systems of valuing revenue over patient care. However, a new report from Deloitte makes the...

Consumer Advocacy Orgs Share How to Move Away From Fee-For-Service Payment

by Victoria Bailey

As healthcare spending rises, shifting away from fee-for-service payment and delivery models that incentivize volume over value is imperative. Families USA and other consumer advocacy groups are urging...

How Can Providers Establish Successful Accountable Care Organizations?

by Victoria Bailey

Accountable care organizations (ACOs) are a common way healthcare providers can transition from fee-for-service to value-based care delivery. In ACOs, providers come together to deliver quality coordinated care to patients while usually...

Overcoming the Barriers to Value-Based Payment in Primary Care

by Victoria Bailey

Primary care is arguably the most critical component of our healthcare system. Primary care and preventive medicine can help avert and manage chronic diseases and prevent long-term complications. However, efforts to improve primary care...

Hospital Finances Approach Pre-Pandemic Levels

by Jacqueline LaPointe

Hospital financial performance is getting back on track after organizations faced the toughest year since the beginning of the COVID-19 pandemic, according to new data from Kaufman Hall and Syntellis...

Healthcare Administrative Spending Increased by 50%

by Jacqueline LaPointe

Administrative costs in healthcare are rising as payers and providers navigate staffing shortages, cybersecurity threats, and other challenges coming off of the COVID-19 pandemic. The eleventh annual...

NYC Partners with Non-Profit to Relieve $2B in Medical Debt for Residents

by Victoria Bailey

New York City will invest $18 million in a program to relieve over $2 billion in medical debt for up to 500,000 New Yorkers. New York City Mayor Eric Adams and New York City Department of Health and...

Healthcare Consumers Want Hospital Price Transparency, Survey Finds

by Victoria Bailey

Healthcare consumers support price transparency, with many wanting hospitals to publish actual prices in advance, not estimates, according to a survey from PatientRightsAdvocate.org. The survey,...

Primary Care Model Did Not Reduce Healthcare Spending or Improve Care

by Victoria Bailey

The CMS Comprehensive Primary Care Plus (CPC+) model was not associated with reduced healthcare expenditures or care quality improvements, a study published in JAMA found. CMS launched the five-year...

Hospital Costs for Inpatient COVID-19 Treatment Rose 26% During Pandemic

by Victoria Bailey

The costs of providing inpatient COVID-19 treatment increased by 26 percent over the first two years of the pandemic, according to a study published in JAMA Network Open. Through the end of 2022,...

The Role of the Hospital Chargemaster in Revenue Cycle Management

by Editorial Staff

The hospital charge description master, or hospital chargemaster, is at the heart of the healthcare revenue cycle, serving as the hospital’s starting point for billing patients and payers. A hospital chargemaster lists all the...

CMS: Healthcare Spending Accelerated, Reaching $4.5T in 2022

by Jacqueline LaPointe

US healthcare spending picked back up last year, reaching a total of $4.5 trillion in 2022, according to the latest numbers from CMS. Healthcare spending growth accelerated, growing by 4.1 percent in...

Fewer Than 1 in 3 Consumers Pay Medical Bills Immediately

by Jacqueline LaPointe

Healthcare revenue cycle leaders may need to readjust their patient collection strategy to help consumers understand and pay their medical bills, a new survey suggests. The survey of over 1,000...

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