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Pulse Magazine

Pulse Magazine

Hospital Consolidation is on the Rise

Hospital consolidation is an increasing trend that is the focus of growing scrutiny from researchers and policymakers who reviewed recent studies on the subject during a roundtable discussion held in May in Washington, D.C., according to the Healthcare Financial Management Association.

During the discussion, the researchers and policymakers disagreed on how to respond to the growth in hospital mergers and acquisitions.  In the first quarter of 2014, 23 mergers and acquisitions occurred, compared to 21 transactions in the first quarter of 2013—a 9.5 percent increase, according to an analysis by Kaufman Hall.

Finance: CFPB Releases Research on Impact of Medical Debt

Recent research released by the Consumer Financial Protection Bureau shows that consumers’ credit may be overly penalized for medical debt that goes into collection and shows up on their credit report.  According to the study, credit scoring models may underestimate the creditworthiness of consumers who owe medical debt in collections. 

The scoring models also may not be crediting consumers who repay medical debt that has gone to collections.

Medical debt is the largest focus of debt collection activity in the U.S., according to the CFPB.  The CFPB’s study considered five million anonymized credit records from September 2011 to September 2013 to assess how well a common credit score predicted a consumer’s future likelihood of paying back debt.

The study found that credit scoring models have not been weighing medical debt very well. It found that if the credit scoring models accounted differently for medical debt in collection and medical debt that is repaid by the borrower, the models could be more precise. 

As the CFPB develops rules for the debt collection industry, questions about inclusion of medical debt in the process remain unanswered. The CFPB has excluded medical debts from much of its work to date. There also remains some question about whether medical debt falls within the bureau’s scope under the Dodd-Frank Act. There are bills in Congress currently that seek to address medical debt credit reporting.

More information: http://1.usa.gov/1nexpFJ

 

News & Notes

Financial Assistance Eligibility Increases

By 2016, according to a study by the Urban Institute and Robert Wood Johnson Foundation, 27.1 million people will still remain uninsured and 37 percent would be eligible for Medicaid, CHIP or subsidized marketplace coverage under the Affordable Care Act.  http://bit.ly/1wmaZ7a 

CMS Announces Official ICD-10 Date

After several delays, including one as a result of a Senate and House vote, CMS says implementation of the ICD-10 medical coding system will be required on Oct. 1, 2015.  http://bit.ly/1iH2rE0

Employer-Paid Health Premiums Nixed by IRS

The Internal Revenue Service is restricting employers from providing their employees tax-free contributions to pay for premiums at health insurance exchanges, according to The New York Times. http://nyti.ms/1oF9Gvy

Health Care HFMA Issues Guide to Navigate Health Care Marketplace

A group of advocacy organizations and consumer groups has released a new guide to help the health care industry improve its price transparency efforts and patients to access price data, according to the Healthcare Financial Management Association.

The Price Transparency in Health Care recommendations were developed to ease patients’ ability to obtain prices as they are responsible for more and more health care costs in today’s market, according to HFMA. “People everywhere want to be smart health care consumers, but information about health care prices is not easily accessible,” said HFMA President and CEO Joseph J. Fifer.

HFMA developed a task force, which includes members from America’s Health Insurance Plans, the American Hospital Association and the Catalyst for Payment Reform, to issue a series of principles for reaching price transparency.  Insurers and providers can use the information to develop their own method to meet the principles.

Key recommendations include: 

·       Health plans should help members estimate their expected out-of-pocket costs based on their current deductible status, along with copayment and coinsurance information.

·       Health plans often have access to price information for many providers in a given region, which they can use to help members factor price into their decision making process.

·       Hospitals should continue to help uninsured patients identify alternatives for sharing their health care costs, including insurance options they may not be aware of.

·       Hospitals should proactively communicate to all patients and community members—including the uninsured—that they may be eligible for financial assistance provided directly by the hospital.

·       Taking insurance eligibility and financial assistance into account, hospitals should offer uninsured people clear information on how to receive price estimates.

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