Insights

The first quarter of 2022 was the worst financial quarter in history for hospitals. Now they’re collapsing under their own weight while payors are raking in profit.

We anticipate seeing a record number of hospital closures in the next six months with financial turmoil continuing for the next two years at least. CEOs across the board are assessing business lines and making difficult decisions to exit services as margin pressures continue to increase.

As the biggest producers of healthcare data, providers must learn how to bring that product to market to transform healthcare experiences and outcomes for the better.

The Transparency in Coverage Final Rules took effect on July 1st. CMS is monitoring for compliance (just like providers), requiring most health plans and health insurance issuers in the individual and group markets to publicly disclose certain pricing information on their website.

Providers should learn from recent convictions to reduce their risk of committing telehealth fraud and abuse as federal oversight is expected to continue.

Three common ways healthcare organizations ignore operational readiness in their Epic implementation process.

The digital data proliferation has also opened doors for information security risk. All hospitals and health systems are at risk no matter size, location or prominence.

On August 26, 2022, the final rules were published by the Internal Revenue Service and the Departments of Health and Human Services, Treasury and Labor (the Departments) addressing the independent dispute resolution (IDR) process and payor “downcoding” (meaning when a payor assigns a service or item a lower level than originally billed).

Telehealth utilization drastically increased during the COVID-19 pandemic. Telehealth fraud dramatically increased too. On July 20, 2022, HHS’ OIG and the Department of Justice (DOJ) announced criminal charges against 36 telehealth companies totaling $1.2 billion for telehealth fraud that they look to recover. 

The headlines about cyberattacks are constant and the costs to organizations and communities are high. Breaches disrupt operational stability and put patients at risk, so it’s no surprise that increasingly savvy healthcare consumers are thinking twice about who they trust with their data.