Becker's Hospital Review

7 CFO / FINANCE Public payer-provider fights increase nearly 70% By Jakob Emerson C ontract negotiation disputes between payers and providers that were reported in the media increased 69% between 2022 and 2023, and the number of communities affected across the country grew as well, according to data published Jan. 16 by FTI Consulting. "Disputes between payers and providers continue to increase, with more individuals, families, and increasingly seniors being impacted due to a rising number of disputes involving Medicare Advantage plans," Citseko Staples Miller, managing director of FTI's healthcare and life sciences public affairs segment, told Becker's. FTI has tracked media reports regarding negotiations over reimbursement rates between provider organizations and insurance companies during each quarter since early 2022. Negotiations reported in the media on or aer Jan. 1, 2023 or later were included in the data. Negotiations that were resolved or did not reach an agreement in 2023, but were first reported in 2022, were counted for 2022's data. If a provider dropped all Medicare Advantage contracts, FTI counted the decision as a single dispute. FTI previously told Becker's that going public with contract negotiations is becoming a more common tactic for healthcare executives, but regulations also require patients to be notified when a network break may occur. Five notes: 1. In 2023, at least 86 disputes were covered in the media, compared to 51 in 2022, or a 69% increase. 2. Public disputes occurred across 34 states in 2023, compared to 24 states during 2022. 3. In 2023, 44% of public disputes failed to reach an agreement, and patients/members went out of network. In 2022, 45% of disputes did not reach a timely agreement. 4. Among the 86 disputes that went public in 2023, 59%, or 51, involved Medicare Advantage contracts. Twelve disputes were exclusively about MA plans. 5. In 2022, 29 of 51 public disputes, or 56%, involved Medicare Advantage contracts, with eight disputes exclusively involving MA plans. n What Bon Secours Mercy Health's CFO is optimistic about in 2024 By Andrew Cass F rom expanding Bon Secours Mercy Health's digital presence to improving cash flow and margins, here is what Deborah Bloomfield, PhD, the Cincinnati-based system's CFO, told Becker's she is most optimistic about in 2024: "Bon Secours Mercy Health is focused on providing quality, compassionate care to every patient who comes through our doors, and this is a responsibility we take very seriously. We are very pleased with the commitment of state Medicaid programs — including recently in South Carolina — that are helping us fulfill our commitment to serving those with great financial need by providing additional reimbursement to help offset some of the losses and costs. "In addition, access to care is essential to ensuring the health and well- being of our communities, and we are working with a variety of partners to ensure the needed expertise and resources are available to help accelerate this access. Patients expect that the right level of care will be available at a time and place that is convenient for them, and we continue to develop ambulatory care options to help meet this need. Our work with digital leader Nordic is helping to expand our digital presence, technology innovations and associated data analytics. This work leads to more tailored and patient-centered options and improved patient outcomes. "While we work to improve access and care for all, we do so with an eye on long-term sustainability which is achieved — in part — through efficient and effective operations. This focus has helped to improve cash flow and margins, which have lagged significantly since the COVID-19 pandemic." n The biggest challenges facing revenue cycle departments in 2024 By Andrew Cass N early half of revenue cycle and fi- nance leaders surveyed said timely patient collections is their biggest concern in 2024, according to a Jan. 23 re- port from Salucro Healthcare Solutions. The health payment technology company's Healthcare Provider Fintech Insights Report is based on a survey of 176 healthcare pro- fessionals. Here are the top five challenges facing RCM teams in 2024, according to the report: 1. Timely patient collections: 48% 2. Managing denials: 36% 3. Hiring and training staff: 32% 4. Data analytics and reporting: 26% 5. Maintaining security and compliance: 13% n

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