National Daily Hospital News Executive Briefing — September 23, 2025
Hospital Margin / Revenue / Reimbursement — Today’s Focus: Hospital Margin
1. Kaufman Hall’s latest National Hospital Flash Report (July 2025 data) shows performance softening as non‑labor expenses outpace revenue growth; use as national margin context.
https://www.kaufmanhall.com/insights/research-report/national-hospital-flash-report-july-2025-data
2. CMS finalized the FY 2026 IPPS/LTCH PPS rule, including a 2.6% payment update and program changes—budget for rate impacts and quality program adjustments.
3. NRHA/Manatt analysis details the new $50B Rural Health Transformation Fund and potential Medicaid reductions—rural leaders should scenario‑plan coverage/margin effects.
4. Case Study as Shared Previously (Revenue Cycle): Moss Adams assessment identified leakage and improved collections/AR for a five‑hospital system—consider external diagnostic for distressed assets.
https://www.mossadams.com/articles/2024/10/case-study-revenue-leakage
Hospital Inpatient Throughput (include Discharge by Time of Day)
1. Peer‑reviewed quality project increased discharges before 11 a.m. from 7%→19% without LOS harm via rounding/AM‑orders and discharge‑readiness huddles.
2. Open‑access cohort project on discharge timing and non‑peak discharges shows sustained gains when pairing criteria‑led discharge with early orders.
https://pmc.ncbi.nlm.nih.gov/articles/PMC11838157/
3. Mass General Brigham reports systemwide progress reducing LOS via Patient Care Progression initiative—leadership governance and daily progression reviews cited.
https://www.massgeneralbrigham.org/en/about/newsroom/articles/improving-patient-care-progression
Hospital Emergency Department Throughput
1. A physician–nurse team adjacent to triage significantly reduced ED LOS (492→425 min), LWBS (6.7%→3.3%), and arrival‑to‑provider time (74→60 min) in a large cohort.
https://www.ceemjournal.org/m/journal/view.php?doi=10.15441%2Fceem.24.248
2. Systematic review finds triage physician presence and fast‑track streaming consistently reduce ED LOS; POCT adds smaller effects.
https://bmcemergmed.biomedcentral.com/articles/10.1186/s12873-024-01163-y
3. JAMA Network Open cohort links ED undertriage to treatment delays for time‑sensitive conditions (e.g., +8.9 min to CT in aortic dissection; +33.3 min to antihypertensives in SAH).
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2833434
Hospital Bed Placement Throughput
1. Narrative review synthesizes interventions that reduce inpatient LOS while maintaining quality (e.g., SAFER bundle, Red2Green, mobility/criteria‑led discharge).
https://pmc.ncbi.nlm.nih.gov/articles/PMC10806560/
2. Open‑access review (2025) outlines strategies to reduce hospital LOS and prevent readmissions—use as a checklist for enterprise throughput programs.
https://pmc.ncbi.nlm.nih.gov/articles/PMC12112870/
3. Mass General Brigham: Stories and metrics on LOS reduction across AMCs and community hospitals; replicable governance cadence described.
Hospital Patient Satisfaction / Engagement
1. Randomized/controlled and quasi‑experimental evidence shows displaying estimated ED waiting times increases patient satisfaction—adopt visible ETA boards/apps.
https://pmc.ncbi.nlm.nih.gov/articles/PMC11864359/
2. AMA STEPS Forward toolkit details concrete workflows to boost portal engagement while limiting inbox burden—pair with communication scripts for results.
https://edhub.ama-assn.org/steps-forward/module/2822815
3. Qualitative study of MyChart experiences identifies facilitators/barriers to portal use; apply findings to reduce disparities in engagement.
https://pmc.ncbi.nlm.nih.gov/articles/PMC11803326/
Patient Safety / Culture of Safety
1. Scoping review maps ED patient safety culture domains perceived by staff—prioritize teamwork, communication openness, and non‑punitive response to error.
https://pmc.ncbi.nlm.nih.gov/articles/PMC12111689/
2. Frontiers review: implementing a Just Culture increases incident reporting and learning; leadership behaviors and fair accountability are foundational.
https://www.frontiersin.org/journals/health-services/articles/10.3389/frhs.2025.1581516/full
3. Study of nurses shows Just Culture mitigates second‑victim effects and negative work outcomes—supporting safer practice and retention.
https://pmc.ncbi.nlm.nih.gov/articles/PMC11837672/
Quality Metrics to Share with Your Team
National margin context: operating performance softened in mid‑2025 as expenses surpassed revenue growth.
https://www.kaufmanhall.com/insights/research-report/national-hospital-flash-report-july-2025-data
FY 2026 IPPS update finalized at +2.6% (market basket + productivity adjustment) impacting 2026 budgets.
https://www.aha.org/news/headline/2025-07-31-cms-issues-hospital-ipps-final-rule-fy-2026
Discharge‑before‑11 a.m. improved from 7%→19% without LOS harm in a 2025 multidisciplinary project.
ED triage physician–nurse team cut mean ED LOS ~67 minutes and halved LWBS (6.7%→3.3%).
https://www.ceemjournal.org/m/journal/view.php?doi=10.15441%2Fceem.24.248
Fast‑track/streaming associated with significant ED LOS reduction across studies (systematic review).
https://bmcemergmed.biomedcentral.com/articles/10.1186/s12873-024-01163-y
SAFER/Red2Green and criteria‑led discharge reduce inpatient LOS while preserving quality.
https://pmc.ncbi.nlm.nih.gov/articles/PMC10806560/
Just Culture interventions associated with increased reporting and reduced negative work outcomes for nurses.
https://pmc.ncbi.nlm.nih.gov/articles/PMC11837672/
Leadership Call to Action
1. Lock in a daily early‑discharge playbook (AM orders, ward huddles, discharge‑by‑11 targets) and track SPC charts by unit.
2. Stand up a triage‑adjacent physician–nurse team and fast‑track streaming during peaks to cut ED LOS and LWBS.
3. Update 2026 budget scenarios using CMS IPPS final rule assumptions and stress‑test expense growth vs. non‑labor trends.
4. Launch an enterprise LOS reduction program (SAFER + criteria‑led discharge + mobility), governed via daily progression reviews.
5. Formalize Just Culture practices—leadership walkrounds, fair accountability policy, and quarterly safety‑culture pulses (AHRQ SOPS).
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📍 Published at National Daily Hospital News
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