Healthcare Workforce Predictions for 2025
The healthcare landscape in 2025 is marked by a complex interplay of financial pressures, persistent workforce shortages, and rapid technological advancements. While healthcare providers have stabilized post-pandemic, they face shrinking revenues coupled with escalating workforce expense, which now comprise a significant portion of total expenses.
Preparing for Potential Disruptions in Federal Funding
The Trump Administration's Executive Order to reduce NIH indirect funding to 15% for institutions conducting medical research including hospitals and universities, has generated significant uncertainty among healthcare providers.
Top Five Issues Facing Health Plans in 2025
As we approach 2025, U.S. health plans across are facing growing pressures stemming from a mix of economic challenges, regulatory complexities and rising consumer expectations. These issues are threatening the financial sustainability of health insurers, impacting the quality of care they can provide, and the overall health outcomes for their members.
The Intersection of Risk Adjustment and Stars
Payers and downstream risk-bearing-entities have historically worked within department silos. In order to succeed under continued regulatory and financial pressures, organizations will still require department expertise but will also need to apply a systems thinking approach.
REPORT: Governance of High Performing Nonprofit Hospital Systems
In a recently published report co-authored by Governance Specialists Larry S. Gage, Alston & Bird Senior Counsel, A&M Managing Director and healthcare industry expert Mark Finucane, and A&M Senior Director Eliza Medearis, our findings highlight the intricate dynamics of nonprofit health system governance.
Profitability Improvement in Medicare Advantage
Medicare Advantage (MA) enrollment exceeds 33 million members, represents $450B in payments from the Federal government, and is expected to double over the next 10 years. Yet, changes to the MA program have reduced overall profitability and challenged payers to adapt.
Payers Have an Opportunity to Expand Value in Home-Based Health
Home-based healthcare can deliver better outcomes, at lower cost, and with a better patient experience. Technology exists to enable the most sophisticated solutions, yet, post-pandemic adoption of virtual services, including hospital at home and many consults, has waned.
Medicaid Redeterminations – The Unintended Consequences
Medicaid redeterminations have moved more than 24 million people off state Medicaid rolls in less than 18 months. While the disenrolled are the most obviously impacted group by this sudden drop, the remaining enrollees and the companies that insure them will also experience the squeeze that comes from a riskier population and a smaller pool of resources.
Managing Medicare Changes Under the Biden Administration
For more than half a century, Medicare had only been available to those 65 and older (or those with qualifying disabilities), but now, the Biden administration is proposing to lower the eligibility age to 60. Under this new policy, an additional 20.8 million people would have access to Medicare coverage.
COVID-Era Rule Waivers: The Government Comes Knocking
This article discusses the impact of enforcement actions for healthcare providers that implemented CMS and HHS rule waivers during the pandemic, as well as shares what actions to take now to ensure government reviews don't make a devasting financial impact.
The New “Normal” for Virtual Medicine
The COVID-19 pandemic accelerated the use of “telehealth” services by healthcare organizations that had previously taken a slow or narrow approach to virtual healthcare.
Expanding Telehealth Services During COVID-19
Telehealth encompasses the technologies and tactics to deliver virtual medical, health and education services. With the COVID-19 pandemic, Medicare and other payors have significantly eased service and billing restrictions on telehealth, posing an opportunity for organizations to supplement or enhance reimbursement revenue during this time of emergency.
Overview of FEMA Public Assistance Program and Application Process
The Centers for Medicare & Medicaid Services (CMS) has expanded its current Accelerated and Advance Payment Program (AAPP) in order to increase cash flow to a broader group of Medicare Part A and Part B providers and suppliers impacted by the 2019 Novel Coronavirus (COVID-19) pandemic.
