The Center for Healthcare Economics and Policy released a report in late January that found no conclusive relationship between hospital consolidation and hospital price increases in communities in the U.S. HFMA wrote that the study “challenges conventional wisdom about the impact of consolidation on hospital prices.” (“Study: Relationship Between Hospital Mergers, Price Increases Often Overstated,” […]
About half of Medicare’s accountable care organizations (ACOs) saved the program money in their first year of operation, but only 25 percent of participants earned a share of those savings, according to an announcement by the Centers for Medicare & Medicaid Services (CMS) on January 30. In 2012, the first year of Medicare’s ACO […]
The American Hospital Association (AHA) announced January 22 that four hospital systems have filed appeals asking the Provider Reimbursement Review Board (PRRB) to grant expedited judicial review for the hospitals’ challenge to certain new payment policies for Medicare Part A inpatient claims, specifically the “two-midnight” rule. (See iProtean newsletter, “Audits Delayed for Two-Midnight Rule,” October […]
The American Hospital Association (AHA) released a fact sheet last week that outlines the amount most U.S. hospitals were “underpaid” by Medicare and Medicaid in 2012. The underpayments affected at least 68 percent of hospitals and totaled $56 billion. “Underpayment” occurs when the payment a hospital received for providing care is less than the […]
The Institute of Medicine’s (IOM) Digital Learning Collaborative and members of the Healthcare Financial Management Association (HFMA) have developed a new model that helps hospital executives and boards assess the return on investment of their electronic health record (EHR) systems and how to best configure these systems “to achieve optimal value,” according to a recent […]
The American Hospital Association released its annual Hospital Statistics guide last week and some of its findings suggest a resilient, quickly adapting hospital industry through fiscal year 2012, according to Modern Healthcare.com which reported on select information from the guide. The guide’s data highlight yet another disconnect among the various organizations that both report […]
Notice: The iProtean Newsletter will be on holiday from December 24 through January 1. Please look for your next newsletter on January 8, 2014. Have a peaceful holiday season and a prosperous New Year! It looks as if a fix to the sustainable growth rate (SGR) formula for paying physicians may be realized in […]
Compliance and risk management efforts of hospitals and health systems should focus on indications from the Department of Health & Human Services (HHS) Office of the Inspector General (OIG) about the direction it intends to take to investigate fraud, waste and abuse. We have talked with OIG investigators over the years who have been straightforward […]
Typically, when a credit rating organization releases projections for the upcoming year, the analysis includes a mix of both positive and negative factors. For 2014, however, Moody’s Investors Service analysts hold no punches; they list the negative factors that led them to a categorical negative outlook, and appear to be hard pressed to find any […]
Note: Because of the Thanksgiving holiday, this week we are publishing an abbreviated version of the newsletter. Next week look for information on Moody’s Investors Service 2014 Outlook for U.S. Not-for-Profit Hospitals. We wish you all a lovely Thanksgiving. When a hospital or system board takes steps to downsize its board, the process […]