Hospitals will receive a 3.1% payment bump for 2024 under a rule recently finalized by the Centers for Medicare and Medicaid Services that sets Medicare reimbursement rates for inpatient, or hospital, care. The final rate increase should boost annual payments by $2.2 billion.
St. Bernards Five Rivers Medical Center is set to become the first hospital in Arkansas to take advantage of a new designation allowing it to receive enhanced federal support in exchange for eliminating most inpatient services.
Already struggling rural hospitals see an increasing financial threat from the steady growth in Medicare Advantage enrollment.
Why it matters: Lacking the bargaining powers of their larger peers who depend on commercial payers to turn a profit, some rural hospitals are losing money on private coverage like Medicare Advantage. The Medicare alternative's popularity with seniors is cutting into a typically better funding source for rural hospitals — traditional Medicare — as hundreds of rural hospitals face down financial calamity.
As a health care economist who studies innovation, and as a management consultant who helps health systems and insurers adopt new technologies, we have had a ringside seat to a frustrating phenomenon: The large private sector of the U.S. health system can move faster to adopt valuable innovations than the public sector burdened by red tape and politics.
But before adopting an innovation at scale, the private sector too often waits for the public sector to take the first step — sometimes for decades.
The No Surprises Act has protected patients from some of the most outrageous out-of-network medical bills since it took effect in 2022 — except for ground ambulances.
When it comes to certain medical conditions, we all have wrestled with the conflagration of differing opinions and the discrepancies in provider documentation.
A common example: The emergency department physician states sepsis, the attending physician writes pneumonia, and the infectious disease specialist documents viral infection. What gives? CDI specialists need to address these situations head on to obtain accurate, specific, and clear documentation. Why do these discrepancies occur and how can we address them?
Though medical schools may vary in how they teach clinical indicators, they follow generally recognized standards and guidelines for clinical practice. These standards are established by professional medical organizations and are based on evidence-based medicine and clinical research.