Morning Briefing
Summaries of health policy coverage from major news organizations
For Many Hospitals, Financial Health Is Teetering
Modern Healthcare: COVID-19 Surge Threatens Hospital Finances
Hospital operating margins are poised to fall as COVID-19 cases increase, new data show. Although the federal relief funding buoyed hospitals, the median hospital operating margin still dropped 1.2 percentage points (8.5%) year over year, and 1.7 percentage points (18.7%) for January through October compared to the same prior-year period, according to Kaufman Hall's analysis of around 900 hospitals. (Kacik, 11/30)
Crain's Cleveland Business: Ohio Hospitals Had Healthy Profit Margins Before Pandemic
The Ohio Health Market Review 2020 offers a snapshot of where hospitals in the state stood before the pandemic, as well as a glimpse into how health insurers fared in the first half of 2020. Hospital profitability increased last year in the Cleveland/Akron, Columbus and Cincinnati/Dayton areas, according to the review, which is the 15th report from Allan Baumgarten, a Minnesota-based independent healthcare analyst who publishes reports on the markets in Ohio and a few other states. (Coutré, 11/30)
Modern Healthcare: Physician Fee-Schedule Changes Could Upend Compensation, Experts Say
Providers are struggling to predict how changes to primary- and specialty-care payments will shake out, because nobody knows how COVID-19 will affect their practices in the next two quarters. They have a month to prepare. The proposed rule would lower the fee schedule's conversion factor from $36.09 to $32.26, a decrease of $3.83 or 10.6%. It would also make several changes to evaluation and management services and codes, including increases in their relative value and changes to coding criteria. Those moves would probably help clinicians that deliver a lot of those services, but proceduralists will see their revenues decline if CMS doesn't make significant changes in its final rule. (Brady, 11/30)
360Dx: Labs Face Turnaround Challenges, CMS Billing Complications
With COVID-19 case numbers rising and CMS set to implement new reimbursement rules at the start of the year, managing test turnaround times will become even more urgent for clinical laboratories. Last month, CMS announced that as of January 1, 2021, it would pay its highest reimbursement rate, $100 per test, to labs that complete high-throughput testing within two calendar days of specimen collection. For tests taking longer than two days, the reimbursement rate will be $75 per test. (Bonislawski, 11/30)
Also —
AP: Teladoc Eyes Several New Phases Of Growth For Telemedicine
Fresh off a big acquisition and riding a wave of customer growth, Teladoc Health is ready to do more for patients. CEO Jason Gorevic said the telemedicine provider can play a big role in helping people manage high blood pressure, diabetes or other chronic conditions. Plus he wants customers to think well beyond primary care when they consider telemedicine, which involves care delivered remotely, often with a live video connection through smartphones or tablets. (Murphy, 11/29)
