Big changes for healthcare finance and FierceHealthFinance

In the nearly three years since I became editor of FierceHealthFinance, many things in this arena have changed.

The conduct of Accretive Health in Minnesota regarding patient collections and Steven Brill's landmark Time magazine article on hospital price transparency have become mainstream media issues. Hospital construction, hospital mergers and their alignment with community needs have placed a laser-like focus on whether growth is being undertaken for the sake of patients or the sake of the bottom line.

Those issues--and how the Affordable Care Act (ACA) will unspool in the critical year ahead--are among the reasons FierceHealthFinance has just expanded to a twice-weekly publication on Tuesdays and Fridays.

Readers will enjoy the upside of a now twice weekly dose of news that is important to them and their jobs, although my column will continue to publish just once a week  on Tuesdays (a fact many would also consider to be an upside).

To that end, I wanted to discuss the top five topics I believe will be hot in the coming months, and will benefit from FierceHealthFinance's expanded coverage:

1. Medicaid expansion. This may be the most critical financial issue facing hospitals at the moment. Since the U.S. Supreme Court ruled last year that it is optional for states to expand their Medicaid programs under the ACA, only about half have agreed to do so. This could create a financial unbalance among hospitals in states that expanded Medicaid and those that have not. It will be interesting to see how this might impact national hospital chains and their operations moving forward.

2. RACs and observation care payment rules. RAC audits have brought the blood of hospital finance executives to a slow boil over the past several years. The lobbying of Congress to rein in RACs and revise observation care rules is building momentum. Expect to see some major developments here soon.

3. Mergers, acquisitions and sales of ancillary businesses. Activity in the hospital sector has grown slowly over the past couple of years, stymied in part by the lingering effects of the Great Recession. But the onset of the ACA should prove a catalyst for more deals. Additionally, hospitals are shedding their ancillary businesses, such as laboratories, as witnessed by several large sales there in the past several months. Expect to see such deals continue to accelerate.

4. Patient collections. That the Healthcare Financial Management Association announced recently that it wanted to introduce new collection guidelines for patients suggests that the criticism the industry has endured in recent years has finally brought the issue to the fore. Expect to see some changes here soon, but don't anticipate patient satisfaction to magically rise as a result--patients will still receive big bills, and they will still be unhappy paying them.

5. Price transparency. Brill's article led directly to the Centers for Medicare & Medicaid Services' recent release of hospital pricing for the 100 most commonly billed procedures. Although the move generated a lot of media attention, both the Web-based spreadsheet and the downloadable Excel version are unwieldy to use. That, taken with the fact that out-of-pocket costs continue to rise and more people will have insurance with fairly big deductibles as a result of the ACA, means more pressure will come to bear on hospitals to come clean on what services and procedures cost and how much they charge patients for them.

If you have any other ideas about potential big healthcare finance stories in the near-term or comments about the expansion of our coverage, please let me know.- Ron (@FierceHealth)