Healthcare Finance News


Nonprofit healthcare sector sees negative financial outlook due to COVID-19; positive outlook expected for pharma

Because there’s such a high level of uncertainty, the risk of a more severe economic impact is elevated and expenses will rise.


Revenue Cycle Management

Managed care, revenue cycle performance strategies are critical to increasing payer yield

Understanding contract loopholes, and being self-advocates during negotiations, can help community hospitals increase their collections.


Strategic Planning

Forecasting the future of HL7 FHIR at HIMSS20

In Orlando, health IT professionals will get an update on what FHIR currently can and can’t do – and what to expect from it going forward.


Capital Finance

Telehealth a target for venture capitalists as its potential to diagnose coronavirus grows

Faster internet speeds, better tech and avoiding other potentially sick patients is pushing investors to pump money into the remote-care space.


Supply Chain

President Trump to invoke Defense Production Act

The Department of Defense is releasing up to 2,000 ventilators and is making available up to 5 million N95 face masks from reserves.



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.


Quality and Safety

COVID-19 survey shows 85% of primary care practices lack personal protection equipment and tests

Physician are frustrated at not having what they need and concerned that they could have been exposed and are infecting patients without knowing it.


Billing and Collections

One in 5 operations may lead to surprise bills, even when the surgeon and hospital are in-network

The average potential surprise bill ranged from $86 for medical imaging specialists to more than $8,000 for surgical assistants.


Claims Processing

Blue Shield of California to cover whole genome sequencing of critically-ill children

Insurer will cover rapid and ultra-rapid whole genome sequencing done by Rady Children’s Institute for Genomic Medicine.



Retrospective denials, prior authorization may be straining hospital and patient finances

While not all insurers may be aware of it, prior authorizations can have detrimental downstream financial effects for hospitals and health systems.


Medical Devices

Apple is developing custom health information tracking chips

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


Compliance & Legal

Michigan doc charged in $120 million healthcare fraud, money laundering scheme

Francisco Patino was allegedly portrayed as a legitimate doctor through the publication of a diet book and plan described as the “next Atkins.”


Policy and Legislation

CMS offers quality reporting relief as providers battle COVID-19

It’s granting exceptions and extensions from reporting requirements for clinicians and providers participating in Medicare programs such as MIPS and Shared Savings Program ACOs.


Community Benefit

Advocate Aurora Health contributed $2.1 billion to community charitable care and services in 2018

The nonprofit health system has sponsored numerous programs and services that help address social determinants of health.


Accountable Care

NAACOS urges CMMI to release more information on new payment model

Lack of information on key financing aspects is preventing ACOs from signing on, says NAACOS president.


Acute Care

Critical care improvements may differ depending on a hospital's patient population

There was a 2% drop in ICU deaths at non-minority hospitals, but the same improvement rate was not seen at minority-serving hospitals.


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.



How analytics, SDOH insights are helping reduce ED use

At HIMSS20, one physician association will show how data-driven care management, with prompt patient outreach, helped decrease ED use by 8%.


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.


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.


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.


Medicare & Medicaid

CMS issues recommendations on adult elective surgeries, nonessential procedures during COVID-19

Healthcare providers should encourage patients to remain home unless there is an emergency to protect others and limit their exposure.


Patient Engagement

Most health insurance enrollees don't understand how their coverage works for COVID-19 coronavirus

At the same time, 64% say they could not afford to pay out their full annual deductible if hospitalized for treatment of the coronavirus.



Scipher Medicine has developed a blood test expected to save payers billions each year

Optum Ventures is among companies investing $25 million, betting on the company’s ability to show for which patients Humira doesn’t work.


Population Health

Almost three quarters of patients with chronic illnesses feel more at risk for COVID-19

Epidemiologists have identified those with chronic medical conditions as one of the key groups at risk of poor outcomes from the coronavirus.


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.”



Virtual health: From Camp Fire to coronavirus

Paradise Medical Group is running a virtual practice as the federal government has announced expanded access to telehealth services.


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