Seeking to improve healthcare for Medicaid beneficiaries, CMS issues a flurry of regulations
CMS over the last month published a trio of final rules intended to make the Medicaid program work better for beneficiaries, with implications for healthcare providers. The three rules address eligibility and enrollment, access and Medicaid managed care. Streamlining eligibility and enrollment The first rule addresses administrative barriers in an effort to simplify enrollment processes…
Navigating toward successful contract negotiations with health plans
A group of healthcare leaders discuss various tactics they are using to negotiate better rates with payers and ensure payers’ commitment to accurate, timely payment.
Shawn Stack: The value of revisiting policies and processes for financial assistance
The charity care processes adopted by healthcare providers have attracted criticism in media stories focusing on the high cost of care. On a recent episode of HFMA’s “Voices in Healthcare Finance” podcast, HFMA Policy Director Shawn Stack discussed the value of revisiting financial assistance policies and processes. Below is an excerpt from the interview. Erika…
Reimagining charity care
Depak Manmohan Goyal, MD, MBBS, MBA, executive director for revenue cycle and supply chain at Monument Health, remembers the case of a 40-year-old patient with late-stage cancer who sought care at the Rapid City, S.D., health system a few years ago before succumbing to her disease. An earlier and unrelated care episode ideally would have…
Healthcare Blame Game: New York Times medical debt piece dubbed ‘laziest story of the year,’ plus revisiting charity care policies
Brad examines a New York Times article by investigative reporter Sarah Kliff about a recent study of patients whose debt was eliminated by RIP Medical Debt. Researchers say the results surprised them.
It’s time to revisit your charity care policy
The cover story in the May issue of hfm focuses on a South Dakota health system that developed a new process to identify charity care patients. In this episode, HFMA Policy Director Shawn Stack discusses why good financial assistance policies and process are essential to patient care.
Three Questions to Ask your RCM Vendor Right Now
All RCM vendors say they take tech, talent, and problem-solving seriously. But do they? Download the white paper to consider some hard-hitting questions.
Hospital Prices Machine Readable File: Build vs Buy Guide
Download this guide to assist you as you run the numbers and study the facts to decide whether or not to build your own MRF(s).
Battle of the Bots: As payers use AI to drive denials higher, providers fight back
Two fighters face each other in the ring, circling together, assuming there will be a single victor. One, representing the U.S. health insurance industry, has made huge investments in aggressive technology over the past several years to automate claim processing and reviews, making it hard for the other fighter — representing the nation’s healthcare providers…
Cyberattack on Change Healthcare brings turmoil to healthcare operations nationwide
Highlights April 9: A possible second ransom demand March 28: Issues with transmitting files to and from payers March 26: A list of payer contacts for providers to inquire about advance payments March 22: An update on the restoration of claims submission March 14: An FAQ on Medicare accelerated and advance payments March 6: Recommendations…