Healthcare Finance News


Reimbursement

U.S. hospitals are suffering financial damage due to COVID-19 pandemic, Kaufman Hall finds

Margins significantly across broader health systems, which often include substantial physician and ambulatory operations outside of the hospital.

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Strategic Planning

What hospitals and health systems can do to recover financially from COVID-19

Setting targets, focusing communication and getting buy-in from the entire organization will be necessary to succeed.

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Capital Finance

Coronavirus is impacting the financial health of nonprofit hospitals, but CFOs have some options

Revenue is tanking, while expenses are going up, as organizations prepare for big surges in coronavirus cases.

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Supply Chain

IBM launches blockchain network to bolster medical supply chain during COVID-19

Rapid Supplier Connect is designed to help health systems and government agencies identify and onboard alternative vendors when certain supplies and PPE are in shortage.

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Budgeting

A dynamic healthcare budget process may trump traditional budgeting in terms of accuracy, flexibility

With a labor-intensive budgeting process that provided little business value, OSF Healthcare decided it was time to be more flexible.

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Quality and Safety

Prior authorization requirements have been eased during the COVID-19 pandemic, but frustrations remain

Providers should seek ways to automate the process as much as possible to curtail the manual work involved.

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Billing and Collections

Blue Shield of California is offering providers up to $200 million during COVID-19 crisis

Nonprofit insurer is working with two financial-services partners to provide financing guarantees, advance payments and restructuring of contracts.

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Claims Processing

Humana is expediting claims processing and prior authorization during COVID-19 pandemic

Prior authorization requirements have hindered freeing up hospital beds due to delays in getting inpatients to post-acute care.

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Workforce

Healthcare professionals mental health suffering even more than that of general public due to COVID-19

The general public experienced a similar arc, though it hasn’t sunk as low as that of their healthcare counterparts since the pandemic took root.

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Operations

Insurers' credit profiles can withstand coronavirus costs, Moody's says

U.S. health insurers will remain profitable under the most likely scenarios, despite the highly uncertain severity and duration from COVID-19.

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Medical Devices

Apple is developing custom health information tracking chips

The custom sensor would measure information from the body beyond heart rate, report says.

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Compliance & Legal

Supreme Court rules for insurers in risk corridors case

The ACA promised the funds for three years to make up for any losses by insurers for jumping into the market and keeping premiums relatively low.

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Community Benefit

Cigna, New York Life create fund for grieving families

The Brave Heart Fund is starting with seed funds of $25 million with the goal to raise at least $100 million.

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Accountable Care

More than half of ACOs likely to leave Medicare Shared Savings program

NAACOS and others want CMS to hold harmless providers participating in alternative payment models from performance-related penalties for 2020.

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Acute Care

Predictive analytics needs a bedside, rather than scientific, manner

A continuous cardiorespiratory monitor uses a much larger data set for an analysis of risk for a subacute, potentially catastrophic, illness.

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Ambulatory Care

Medical schools, teaching hospitals account for 3% of US GDP, report shows

The institutions that were studied added more than $562 billion in value to the nation’s economy in 2017, including direct and indirect economic impact.

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Analytics

How data is presented to clinicians can make work more efficient, bend the cost curve

Integrating cost and clinical-decision-support information reduced medication errors and burnout prevalence at Houston Methodist.

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Business Intelligence

While the price of healthcare is growing, utilization is dropping and price variations persist, report says

Report analyzed more than 1.8 billion commercial healthcare claims and data visualization to benchmark prices and use across 112 metropolitan areas from 2012 to 2016.

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ICD-10 & Coding

Physician practices examine risk adjustment coding in wake of federal lawsuits

Doctors need to carefully and properly use the HCC codes, which indicate the expected costs for a patient.

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Meaningful Use

CMS overhauls meaningful use EHR program, renames it 'Promoting Interoperability'

Administrator Seema Verma said changes to the program eliminate 25 measures and saves hospitals over 2 million hours of work and $75 million.

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Patient Engagement

One in seven Americans would avoid care for suspected COVID-19 fearing cost of treatment

Even when asked to suspect themselves infected, 9% would still avoid treatment, suggesting gaps in coverage or poor finances.

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Pharmacy

Drug shortage management strategies are needed during COVID-19 pandemic

Leveraging regulatory allowances and establishing sound analytic capabilities can help ensure patients continue treatment with necessary drugs.

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Population Health

Humana is waiving costs for all primary care and behavioral health visits for MA members

Cost sharing is being waived for in-network primary care, behavioral health and telehealth visits.

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Risk Management

Cybersecurity needs to be put in business terms

IT security is a legacy word, says Brian Selfridge: “This isn’t cybersecurity, this is risk.”

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Telehealth

HHS awards $20 million to increase telehealth access

HRSA’s Federal Office of Rural Health Policy awarded $5 million to develop cross-state licensure for clinicians.

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