Tag: Medicaid

Trump record, Republican National Convention hint at GOP healthcare policy priorities

Editor's Note As the Republican National Convention meets in Milwaukee to nominate Donald Trump, the party is not expected to unveil a detailed healthcare platform. However, a July 15 report in Modern Healthcare covers what plans and past records reveal about the potential direction of health policy under a GOP…

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By: Matt Danford
July 15, 2024
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Hospitals, health groups criticize CMS pay proposals

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Editor's Note Hospital groups are criticizing CMS' proposed 2.6% pay increase for 2025, deeming it insufficient for nonprofit hospitals with operating margins near or below zero, according to a July 11 article in Becker’s Hospital CFO Report. The American Hospital Association and America's Essential Hospitals argue the rise won't cover…

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By: Matt Danford
July 12, 2024
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CMS releases proposed Medicare payment rates for outpatient, ASC services

Editor's Note On July 10, CMS proposed Medicare payment rates for hospital outpatient and ambulatory surgery center (ASC) services for 2025.  Published annually, the Hospital Outpatient Prospective Payment System (OPPS) and ASC Payment System Proposed Rule will have a 60-day comment period, which this year ends September 9 prior to…

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By: Matt Danford
July 10, 2024
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US healthcare spending growth expected to outpace overall economic growth

Editor's Note Expected to grow at an average annual rate of 5.6%, US healthcare spending will outpace GDP growth—projected at 4.3%--and rise to $7.7 trillion by 2032, according to a June 28 report in ASC focus. The $7.7 trillion figure amounts to 19.7% of GDP. The report is sourced from…

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By: Matt Danford
July 8, 2024
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Rural hospitals contend with challenging opportunities

Rural hospitals in the US have been facing a prolonged, multifaceted crisis. The literature presents several reasons for why healthcare facilities in rural areas struggle, including shrinking budgets, rising chronic illness and public health issues like addiction and obesity, poor telehealth and broadband access, aging populations, deteriorating mental health, and…

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By: David C. Walsh
June 24, 2024
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US healthcare spending outpaces GDP, tracks toward $7.7 trillion by 2032

Editor's Note Growth in healthcare spending is outpacing nominal economic growth, Hospice News reported June 12. Citing a study from the Office of the Actuary (OACT) at the Centers for Medicare and Medicaid Services (CMS), the outlet reports that healthcare spending’s share of GDP is projected to rise from 17.6%…

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By: Matt Danford
June 13, 2024
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Federal regulations require written consent for pelvic exams at hospitals, medical schools

Editor's Note New federal guidelines require obtaining written informed consent before conducting pelvic and other sensitive medical examinations, according to an April 2 Associated Press report. The new guidance from the US Department of Health and Human Services focuses specifically on medical students, nurse practitioners, and physician assistants performing breast,…

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By: Matt Danford
April 15, 2024
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Private payers profit by delaying medical claims

Editor's Note Private payers initially deny reimbursement on 15% of claims, only to later approve more than half of those initial denials, according to a national survey of healthcare institutions published March 21 by Premiere, Inc. Additionally, the denied claims on average tend to be more prevalent for higher-cost treatments…

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By: Matt Danford
April 4, 2024
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Federal probe investigates care quality impact of private equity mergers, acquisitions

Editor's Note Making good on plans announced by the Biden administration in December, federal agencies have launched a public inquiry into how private equity mergers and acquisitions impact patient outcomes, worker safety, and healthcare access and costs, including costs to taxpayers.  As reported by Dotmed Healthcare Business News on March…

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By: Matt Danford
March 14, 2024
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Shift to outpatient, emergency services keeps rural hospitals afloat

Editor's Note More CEOs are considering rural emergency hospital (REH) designation, according to a February 12 article in Becker’s Hospital CFO Report. In January 2023, REH was established as a new Medicare provider type to enable struggling rural hospitals to continue operating with outpatient and emergency services only, instead of…

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By: Matt Danford
February 27, 2024
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