Topics
Reimbursement
Behavioral health should shift to value-based care despite challenges, Evernorth says
Evernorth: Behavioral health should shift to value-based care
Revenue Cycle Management
Modernizing healthcare payment systems starts with reducing cash collections
Modernizing healthcare payment systems starts with reducing cash collections
Strategic Planning
Advocate Health closing Illinois clinics inside of Walgreens
Advocate Health closing Illinois clinics inside of Walgreens
Capital Finance
HIMSS25: ROI as the ultimate measure of value
HIMSS25: ROI as the ultimate measure of value
Supply Chain
Hospitals face rising costs, supply chain disruptions as tariff uncertainty continues
Hospitals face rising costs as tariff uncertainty continues
Accounting & Financial Management
Ambulatory surgery centers drive Tenet's strong Q4 results
Ambulatory surgery centers drive Tenet's strong Q4 results
Budgeting
Health system operating margins declined in August
Health system operating margins declined in August
Quality and Safety
Senate report slams private equity's ownership of hospitals
Senate report slams private equity's ownership of hospitals
Billing and Collections
Revenue cycle challenged by low collection rates, high denials
Revenue cycle challenged by low collection rates, high denials
Claims Processing
Sen. Grassley wants UnitedHealth to hand over MA billing records
Sen. Grassley wants UnitedHealth to hand over MA billing records
Workforce
Cedars-Sinai cancer director stepping down
Cedars-Sinai cancer director stepping down
Operations
Chief growth officer on the competitiveness of home health market
Chief growth officer on the competitiveness of home health market
Medical Devices
Logistics robots bringing Samsung Medical Center into the future
Logistics robots bringing Samsung Medical into the future
Hospital/physician relations
Hospitals, physicians submit opposing views to FTC ruling on noncompetes
Hospitals, physicians submit opposing views to FTC ruling
Construction & Facilities Management
Prisma Health opens $3.7 million behavioral health facility
Prisma Health opens $3.7 million behavioral health facility
Compliance & Legal
Hospitals face deadline to opt out of BCBS settlement agreement
Hospitals face deadline to opt out of BCBS settlement agreement
Policy and Legislation
HIMSS25: What's happening nationally and globally with telehealth, AI and cybersecurity
HIMSS25: What's happening nationally and globally with telehealth, AI and cybersecurity
Community Benefit
Mobile Healthcare does house calls
Mobile Healthcare does house calls
Accountable Care
HIMSS25 session shows how physicians are incentivized in alternative payment models
HIMSS25 session shows how physicians are incentivized in APMs
Acute Care
SDOH, tech key to advancing value-based care, says UHG
SDOH, tech key to advancing value-based care
Ambulatory Care
Fewer clinicians entering primary care, data shows
Fewer clinicians entering primary care
Analytics
Kentucky making data on foster children interoperable
Kentucky making data on foster children interoperable
Business Intelligence
Blue Cross NC reorganizing with parent company
Blue Cross NC reorganizing with parent company
ICD-10 & Coding
Physician practices examine risk adjustment coding in wake of federal lawsuits
Practices keeping close watch on risk adjustment coding
Meaningful Use
Financial disincentives for providers who commit information blocking 
Financial disincentives for providers who commit information blocking 
Medicare & Medicaid
AMA among organizations asking RFK Jr. to reschedule immunization meeting
AMA among organizations asking RFK Jr. to reschedule immunization meeting
Patient Engagement
HHS, Illinois reach agreement on disability rights laws
HHS, Illinois reach agreement on disability rights
Pharmacy
PBMs appeal FTC case over insulin costs 
PBMs appeal FTC case over insulin costs 
Population Health
Obesity rates driving up healthcare costs, report finds
Obesity rates driving up healthcare costs
Risk Management
UPMC for You partners to offer Medicaid redetermination coverage in laundromats
UPMC for You offers Medicaid redetermination coverage in laundromats
Telehealth
Philips partners for maternal remote patient monitoring in Georgia
Philips partners for maternal remote patient monitoring in Georgia
Mergers & Acquisitions
Walgreens to be acquired by Sycamore Partners
Walgreens to be acquired by Sycamore Partners
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Government Accountability Office

Lawyers filling out paperwork
Nov 14, 2024 | Jeff Lagasse
Johnson and Johnson sues HRSA for blocking 340B plan
HRSA informed J&J in August that its rebate model was inconsistent with the 340B statute.
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Executive looking out window
Sep 30, 2024 | Jeff Lagasse
OIG: New York paid $23.3 million in Medicaid payments to deceased beneficiaries
To date, New York has refunded approximately $10 million to the federal government and recovered roughly $19…
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Clinicians at a board table
Sep 26, 2024 | Jeff Lagasse
GAO urges action to prevent Medicaid fraud
GAO identified systemic issues that impair Medicaid's ability to root out fraudulent activities and offered recommendations.
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Pharmacist with customer
Sep 09, 2024 | Susan Morse
PBM executives face penalties if their testimony goes uncorrected 
The deadline to respond is September 11, says chairman for the House Committee on Oversight and Accountability.
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Woman sitting at computer
Aug 26, 2024 | Jeff Lagasse
CMS blocks private sector enrollment sites from ACA marketplace
CMS received more than 200,000 complaints in the first six months of the year about such actions.
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Pills spilling out of a bottle
May 22, 2024 | Susan Morse
Appeals court sides with drug manufacturers in 340B case
The court left room for the possibility of future enforcement if 340B conditions are violated.
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Three in business meeting at table
Mar 28, 2024 | Jeff Lagasse
Of $236B in 'improper payments,' $100B was from Medicare, Medicaid
This is despite payment errors under Medicaid dropping by $30 billion from the previous year.
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AI is not yet 100% accurate, with a tradeoff between risk and productivity for financial savings.
Nov 14, 2023 | Susan Morse
GenAI: Risk vs. reward causing adoption to stall
AI is not yet 100% accurate, with a tradeoff between risk and productivity for financial savings.
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Lawmakers say more is required to ensure nonprofit hospitals’ community benefit information is standardized, consistent and identifiable.
Aug 09, 2023 | Jeff Lagasse
Senators press Treasury, IRS on nonprofit hospitals' tax exemptions
Lawmakers say more is required to ensure nonprofit hospitals' community benefit information is standardized,…
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Healthcare professionals wirh a patient
Jun 12, 2023 | Susan Morse
AI can help hospitals bill complete medical record
Physician-trained AI can recover millions in lost revenue by reducing denials, says Dr. Michael Gao, CEO and cofounder of SmarterDx.
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