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As health systems invest in AI and other patient-facing technologies, leaders are broadening the business case beyond short-term financial returns to include patient loyalty, market share, workforce satisfaction and long-term organizational value. In fact, the pace of patient-facing innovation is testing conventional ROI thinking among healthcare leaders, and it’s changing the way in which CFOs guide discussions about innovation with other senior leaders and their boards.
The U.S. healthcare system is facing a tragedy of the commons, in which each stakeholder is incentivized to act in their own self-interest. That is the focus of Trilliant Health’s report released on Tuesday. Trilliant Health is a healthcare analytics and market research firm. The report examines six trends drawn from Trilliant’s claims database, price transparency data and government and industry sources.
CMS Finalizes Rules to Improve Healthcare Price and Coverage Transparency
The Centers for Medicare & Medicaid Services (CMS) finalized new regulations to make healthcare pricing and coverage information more accessible, reliable, and easier for consumers to use when deciding on care. The changes are intended to give consumers better information about what their health coverage includes and what they are likely to pay before receiving care. The updated rules also aim to make pricing data more useful for employers, researchers and technology developers.
CMS penalizes 2,334 hospitals for high readmissions
CMS is penalizing 2,334 hospitals, about 80% of those evaluated, under the Hospital Readmissions Reduction Program in fiscal 2027, according to new CMS data. The penalties took effect Oct. 1 and reduce hospitals’ base payments from traditional Medicare for inpatient stays. The Hospital Readmissions Reduction Program was developed under the ACA to reduce avoidable hospital readmissions by applying payment reductions to hospitals that have higher-than-expected rates for specific conditions and procedures.
Lawmakers press CMS to roll back proposed restrictions on remote patient monitoring
A bipartisan group of 32 House lawmakers is pressing CMS Administrator Mehmet Oz to roll back proposed Medicare payment changes that would bar remote patient monitoring programs from using third-party clinical staff. The lawmakers argue that the proposal could significantly reduce access to remote monitoring for Medicare beneficiaries, particularly rural patients and those served by small, independent physician practices and hospitals.
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