The ban on surprise medical bills protected patients from more than 10 million claims for out-of-network services in the first nine months of 2023, according to new estimates by health insurers.
Declining reimbursements are among the impacts on a hospital’s bottom line. Even before the pandemic, hospitals in Wisconsin say they have been experiencing difficulties. “Workforce challenges, issues related to reimbursement,” Eric Borgerding, the president and CEO of the Wisconsin Hospital Association, said. Limited reimbursements also restrict hospitals. Borgerding said that’s where the payer mix comes in. A payer mix refers to how the hospital is being reimbursed for the care it’s providing patients, whether through government programs like Medicare, Medicaid or other insurance avenues.
A new survey showed that about half were operating in the red, and the share was even more dramatic for small rural hospitals. Driving that financial picture, says the Nebraska Hospital Association, which released the survey results, are rising workforce and pharmaceutical costs, along with reimbursement coverage gaps from Medicaid and Medicare. At risk if the trend continues unaddressed are cuts ranging from patient medical programs to staff support services such as child care, hospital representatives said during a news conference Monday.
Curtin initiated his health-care journey as an emergency medical technician and seamlessly transitioned to a role within the area of patient access. He progressively advanced from lead roles to his previous position as senior director at Outer Cape Health Services. In this role, he successfully navigated the organization through a Health Resources and Services Administration survey, demonstrating his leadership in orchestrating the strategic plan. His professional focus extends to Patient Family Advisory Councils, patient experience and adeptly leading joint commission surveys.
The initiative is likely to reduce the claim costs of insurance companies as it will help reduce fraud and provide seamless medical assistance to customers, insurance officials said. The General Insurance Council on Wednesday launched the ‘Cashless Everywhere’ initiative aimed at making cashless treatment available for policyholders even in non-empanelled hospitals registered under the Clinical Establishment Act. “Apart from being a great customer convenience and experience-centric initiative, this will also aid in better cost management.
This news comes days after the president of the hospital stepped down amid Steward Health Care’s financial crisis. “After hearing that certain surgical equipment may not be available, we made the decision to reschedule upcoming orthopedic and GI procedures at Holy Family Hospital,” said Tom Sequist, Chief Medical Officer for Mass General Brigham. “We have contacted impacted patients, and we are working to reschedule their procedures as soon as possible at a nearby Mass General Brigham or community hospital location.”