New analysis from Families USA shows that hospitals are charging commercial plans far more than what Medicare pays for services, highlighting the hospital industry's role in rising medical costs.
The four largest hospital systems in the country use their market dominance to overcharge customers relative to the Medicare rate, Families...CMS Rules
This week, the Centers for Medicare and Medicaid Services (CMS) published its 2026 Outpatient Prospective Payment System (OPPS) proposed rule which would raise reimbursement for hospitals and ambulatory surgical centers (ASCs) by 2.4%. The proposal also puts forward a site-neutral policy, which would allow CMS to reimburse at the same...National News
Nonprofit hospitals pledge to elide financial incentives for a higher commitment to quality of care and community investment in exchange for tax exemption, but giant nonprofit hospitals that generate huge revenue streams are coming under scrutiny.
A recent study showed that 7% of nonprofit hospitals were the beneficiaries of over half...Top of The Day
It looks as though hospitals are finally starting to bounce back from the economic turbulence brought on by the COVID-19 pandemic.
According to the latest National Hospital Flash Report by Kaufman Hall, November 2023 demonstrated stability and growth in the hospital sector with operating margin improvements. Nationally, operating...Top of The Day
A new report by Syntellis and the American Hospital Association (AHA) could drive the fight between hospitals and Medicare Advantage providers to reach a head, as the analysis shows MA plans' claims denials are directly contributing to declines in cash reserves.
Claims denials increased 56% for the median hospital between January 2022...National News
According to Kaufman Hall, U.S. hospitals and health systems are off to a bad start in 2022 with February hospital operating margins still in the red for a second consecutive month as healthcare providers continued to feel the repercussions of the Omicron surge.
COVID-19 cases and hospitalizations plummeted in February from...National News
On Monday, the Supreme Court declined to take up a lawsuit over the Trump administration Center for Medicare & Medicaid Services's (CMS) Medicare Part B pay cuts for outpatient clinic visits at off-campus hospital facilities. In February, the American Hospital Association (AHA), America's Essential Hospitals and the Association of...National News
Amid a pandemic that has caused people to avoid the hospital, health systems and hospitals are suffering financially. According to a Kaufman Hall report released this week, hospital operating margins have declined by 18.7% since the start of this year to the end of October.
The poor margins are driven by declining patient...CMS Rules
Along with an increase to Medicare inpatient payment rates, a Centers for Medicare and Medicaid Services (CMS) proposed rule released on Monday is suggesting price transparency requirements that include hospitals disclosing median payer-specific rates negotiated with Medicare Advantage organizations and third-party payers.
CMS is...Arizona News
According to a poll conducted by Arizona State University’s Morrison Institute, healthcare is the foremost concern among the state’s rural population.
Water quality and health insurance tied for first place with 79% of respondents rating the importance of the two issues as either an 8, 9, or 10, on a scale of 1-10. In light...National News
Skilled nursing facilities (SNFs) get some insight into the selection process used by Medicare accountable care organizations (ACOs). Some of the coordination strategies include home visit programs and the exchange of data between primary care and emergency departments.
The strategies are outlined in a new Centers for Medicare and...
