National Daily Hospital Executive Briefing Thursday 08/28/25 Vol. 1

 

Forward

The pace of change in healthcare can feel overwhelming, but clarity comes from stepping back and distilling what matters most. This daily update highlights a handful of new findings and practical innovations that directly affect hospital operations, patient care, and workforce planning. Each section includes original sources so you can dig deeper as needed. My aim is to provide you with a clear, concise resource you can rely on — one that saves you time and sparks ideas for action.

Daily Hospital Ops Update — Thu, Aug 28, 2025 (08:30 PT)

Fast, exec-ready brief across today’s CMS rules, price transparency, CA SB 525, workforce, ED flow, referral leakage, and hiring regs—each with primary sources linked for quick action.

1) CMS Payment Rules (IPPS / OPPS‑ASC / PFS)

• FY 2026 IPPS Final Rule (acute + LTCH) — final published Aug 4; CMS hub live with rule text, tables, and impact files. Priorities: payment updates, measure changes (IQR modifications/removals), and LTCH updates.
  Link: CMS IPPS Final hub → https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/fy-2026-ipps-final-rule-home-page. Centers for Medicare & Medicaid Services
  Federal Register (display PDF): https://public-inspection.federalregister.gov/2025-14681.pdf. Federal Register Public Inspection
  
  

• CY 2026 OPPS/ASC Proposed Rule — comment window open (CMS says comments due Sept 15). Review outpatient rate updates, PHP/IOP policies, and transparency items.
  Link: CMS Fact Sheet → https://www.cms.gov/newsroom/fact-sheets/calendar-year-2026-hospital-outpatient-prospective-payment-system-opps-and-ambulatory-surgical. Centers for Medicare & Medicaid Services
  CMS OPPS page (deadline call‑out) → https://www.cms.gov/medicare/payment/prospective-payment-systems/hospital-outpatient. Centers for Medicare & Medicaid Services
  
  

• CY 2026 Physician Fee Schedule (PFS) Proposed Rule (+ QPP/MSSP changes) — comments due Sept 12. Key items: conversion factor updates, QPP policy proposals, and MSSP adjustments (e.g., BASIC track one‑sided risk max 5 years starting with 2027 agreements; quality/assignment tweaks).
  PFS Fact Sheet → https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2026-medicare-physician-fee-schedule-pfs-proposed-rule-cms-1832-p. Centers for Medicare & Medicaid Services
  Docket page (CMS‑1832‑P) → https://www.cms.gov/medicare/payment/fee-schedules/physician/federal-regulation-notices/cms-1832-p. Centers for Medicare & Medicaid Services
  MSSP/ACO Fact Sheet (within PFS rule) → https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2026-medicare-physician-fee-schedule-proposed-rule-cms-1832-p-medicare-shared. Centers for Medicare & Medicaid Services
  
  

2) QPP / MSSP ACO (what to scan this week)

• QPP resources for CY 2026 proposals — compare policy tables and submission details.
  Link: QPP Resource Library → https://qpp.cms.gov/resources/resource-library. qpp.cms.gov
  
  

3) Hospital Price Transparency (MRF compliance & enforcement)

• CMS HPT RFI on accuracy/completeness (closed July 21) + guidance on encoding dollar amounts in MRFs; ongoing enforcement dataset updated July 23, 2025.
  Overview page → https://www.cms.gov/priorities/key-initiatives/hospital-price-transparency. Centers for Medicare & Medicaid Services
  Guidance (encode dollar amounts) → https://www.cms.gov/files/document/updated-hpt-guidance-encoding-allowed-amounts.pdf. Centers for Medicare & Medicaid Services
  Enforcement dashboard → https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-price-transparency-enforcement-activities-and-outcomes. CMS Data
  
  

4) California SB 525 Healthcare Minimum Wage (today’s operational takeaways)

• DIR FAQ + posted schedules — confirm which tier you’re in and the July 1, 2025 step‑ups for covered employers; mind exempt‑salary thresholds tied to health‑care minimum wage.
  DIR FAQ → https://www.dir.ca.gov/dlse/Health-Care-Worker-Minimum-Wage-FAQ.htm. CalDIR
  Practical briefing on July 1, 2025 increases → https://www.shrm.org/topics-tools/employment-law-compliance/california-health-care-minimum-wage-increase-effective-july. SHRM
  Note: SB 828 (trailer bill) adjusted certain effective dates (1‑month delay language). Text tracker → https://legiscan.com/CA/text/SB828/id/3000775. LegiScan
  
  

5) Workforce / Recruitment / Retention

• BLS: Health care added +55,000 jobs in July 2025 (Hospitals +16k; Ambulatory +34k).
  BLS News Release → https://www.bls.gov/news.release/empsit.nr0.htm. Bureau of Labor Statistics
  
  

• AHA Workforce Scan (2025) — tech‑enabled staffing, upskilling, flexible models.
  AHA page → https://www.aha.org/aha-workforce-scan. American Hospital Association
  
  

6) ED Boarding & Patient Access (ED/OR/LOS)

• Evidence update: JAMA Network Open analysis of CMS’s proposed Emergency Care Capacity & Quality (ECCQ) framework shows worsening access: prolonged ED LOS (>8h) rose from 7.8% → 13.9% (2017–2024); inpatient boarding (>4h) 2.6% → 6.2%.
  Article → https://pmc.ncbi.nlm.nih.gov/articles/PMC11992599/. PMC
  
  

• Emergency preparedness/OIG — July 29 report urges CMS to strengthen AO standards/training (implications for surge/boarding plans).
  HHS‑OIG audit → https://oig.hhs.gov/reports/all/2025/cms-should-take-additional-actions-to-help-hospitals-prepare-for-a-future-emerging-infectious-disease-outbreak/. Office of Inspector General
  
  

7) Referral Leakage (revenue capture & access)

• MGMA: referral monitoring boosts volume/revenue; use payer data + EMR to identify leakage.
  MGMA briefing → https://www.mgma.com/articles/impact-on-volume-and-revenue-of-referral-management-monitoring. mgma.com
  
  

• Industry snapshot (context): network navigation failures drive leakage; tactical playbook emerging.
  Hospitalogy → https://hospitalogy.com/articles/2025-04-21/the-health-system-navigation-problem-and-why-you-should-fix-your-leaky-referral-pipeline/. Hospitalogy
  
  

8) Hiring‑Related Regulation (FTC noncompetes)

• Status: The FTC’s nationwide noncompete ban remains blocked (N.D. Tex. Aug 2024); appeals placed in abeyance in 2025 while FTC reconsidered; agency has signaled potential pullback. Keep operating under state law patchwork.
  FTC page (rule + injunction note) → https://www.ftc.gov/news-events/news/press-releases/2024/04/ftc-announces-rule-banning-noncompetes. Federal Trade Commission
  Recent analysis (Aug 15, 2025) → https://www.wilmerhale.com/en/insights/publications/20250815-post-mortem-on-the-ftcs-blocked-non-compete-rule. WilmerHale
  Fifth Circuit docket update synopsis → https://www.bswllp.com/the-status-of-the-ftcs-noncompete-rule-in-the-fifth-circuit. bswllp.com

#HospitalOps

#CMS

#HealthcareWorkforce

#PriceTransparency

#CaliforniaSB525

#EDBoarding

#Noncompetes

#HospitalLeader

#NursingExecutive

#NursingLeader

#EmergencyPhysician

#Nursing

#Hospitals

ER / Surgery / Inpatient / Outpatient Throughput, Recovery and Wrap-Around: The Teams You Need for a Successful Throughput Project

Too often, hospitals attack throughput one silo at a time. But true improvement comes only from connecting ER, surgery, inpatient, outpatient, and homecare into a single, coordinated system of care.

Over the years, I’ve seen certain teams consistently deliver this kind of success. These 14 teams improve flow, raise satisfaction, reduce readmissions, and boost productivity. Here are the ones you need for a successful throughput project:

1. Core Leadership / Steering Team

(Sets vision, secures resources, and ensures alignment across the system)

2. Emergency Department Throughput Team

(Drives flow from arrival → triage → evaluation → admission/discharge)

3. Surgical Pre-Op & Scheduling Team

(Pre-admission testing, optimization, and efficient case scheduling to prevent cancellations and delays)

4. Surgical Services Flow Team

(OR throughput: reducing turnover, aligning block schedules, optimizing case flow)

5. Inpatient Flow & Discharge Team

(Coordinates hospitalists, nursing, case management, pharmacy, social work for timely discharges and LOS optimization)

6. Patient Experience & Engagement Team

(Builds trust and satisfaction through bedside reporting, clear communication, and education)

7. Quality & Safety Improvement Team

(Prevents errors, reduces infections, and ensures bundle compliance)

8. Productivity & Workforce Optimization Team

(Aligns staffing with demand, flexes resources, and reduces overtime while improving retention)

9. Cross-Functional “Rapid Action” or Kaizen Teams

(Pop-up groups that fix bottlenecks in transport, EVS, lab turnaround, or bed assignment)

10. Transitional Care Management (TCM) Team

(Supports smooth handoffs post-discharge through follow-ups, med reconciliation, and early appointments)

11. Outpatient Clinic Scheduling & Productivity Improvement (OPSI) Team

(Improves clinic access, provider productivity, scheduling efficiency, and no-show recovery)

12. Referral & Leakage Recovery (RLR) Management Team

(Closes referral gaps, reduces outmigration, and grows in-system specialty services)

13. Outpatient & Homecare Team

Ensuring continuity of care in the community and home setting

Initiatives: home visits, telemonitoring, chronic care management, patient education, coordination with specialists

14. WAID: Weekly Ai Analytics, Dashboards and Integrated Throughput Tools

(Builds Analytics, Real-Time tools and analyses to support the above)

Later this week we will provide a detailed list of Metrics for each team.

Why These Teams Work

Shared ownership: Every link has a champion.

Accountability & data: Each team owns and tracks specific KPIs.

Front-line engagement: The people closest to the work redesign the work.

Leadership sponsorship: Barriers get removed quickly.

#Hospitals

#HospitalExecutive

#HospitalLeader

#Nursing

#NursingLeader

#EmergencyServices

#SurgicalServices