National Daily Hospital News – Executive Briefing
Thursday, October 30, 2025
1. Selected Topics
1A | Hospital Margin / Revenue / Reimbursement
Margins slipping again as volumes cool and expenses creep up.
Kaufman Hall’s National Hospital Flash Report (Aug 2025) shows median operating margin trending down as non-labor expenses rise.
https://www.kaufmanhall.com/insights-reports/national-hospital-flash-reportHealthLeaders: “margins softening as expenses catch up.”
Independent summary pegging median margin at ≈ 1.7 % YTD, the year’s low point.
https://www.healthleadersmedia.com/ceo/hospital-margins-softening-expenses-catchCMS FY 2026 IPPS Final Rule = payment lift, not a margin cure.
CMS projects ≈ $5 billion in higher hospital payments for FY 2026, mainly via market-basket and wage-index adjustments; effects vary by service line.
https://www.aha.org/news/headline/2025-07-31-cms-issues-hospital-ipps-final-rule-fy-2026
https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/fy-2026-ipps-final-rule-home-pageKeep reimbursement radar on proposed/related rules.
CMS fact sheet and Federal Register publication outline detailed DRG and LTCH adjustments; review wage-index shifts in local modeling.
https://www.cms.gov/newsroom/fact-sheets/fy-2026-hospital-inpatient-prospective-payment-system-ipps-and-long-term-care-hospital-prospective
https://www.federalregister.gov/documents/2025/06/05/2025-10261/medicare-program-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-and-thePolicy wind still favors hospital-at-home flexibility.
AHA’s Sept 2025 statement on Hospital Inpatient Services Modernization Act (H.R. 4313) signals ongoing bipartisan support for flex capacity and rapid discharges.
https://www.aha.org/testimony/2025-09-17-aha-statement-house-committee-ways-and-means-hospital-inpatient-services-modernization-act-hr-4313Documentation/coding world echoes same caution.
CDI Strategies (June 2025) notes volume-driven revenue gains are fragile amid rising uncompensated-care and staffing costs.
https://acdis.org/articles/news-us-hospitals-see-positive-financial-developments-2025-challenges-remain-report-says
1B | Emergency Department Throughput & Patient Flow
AHRQ ( Mar 2025 ): ED boarding is a hospital-wide problem.
Systemic fixes must target capacity, discharge timing, and post-acute access.
https://www.ahrq.gov/news/newsletters/e-newsletter/951.htmlED boarding cuts transfer acceptance ≈ 29 %.
JAMA Network Open (2025) found transfer odds drop to 0.71 (aOR) in the worst-boarding quartile — a measurable regional-access risk.
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2834521
https://pmc.ncbi.nlm.nih.gov/articles/PMC12120653/Vizient ( Jun 2025 ): National ED overcrowding persists.
2019–2022 saw ≈ 30 000 beds removed; rising acuity will worsen crowding through 2035.
https://www.vizientinc.com/insights/all/2025/from-every-angle-emergency-department-overcrowdingACEP Quality & Patient Safety ( Feb 2025 ): operations-level playbook.
Boarding, internal holds, early inpatient-ready criteria — a strong model for ED and hospitalist collaboration.
https://www.acep.org/qips/newsroom/winter-2025/optimizing-throughput-in-the-emergency-department-one-institutions-experienceDischarge-before-noon as throughput lever.
Valparaiso University (2025 EBPR project) links late discharges to extended LOS; structured discharge-by-noon programs improve bed availability.
https://scholar.valpo.edu/cgi/viewcontent.cgi?article=1213&context=ebprPeer-reviewed 2025 LOS-reduction summary.
Multidisciplinary rounds + enhanced-recovery pathways shorten LOS without higher readmits.
https://pmc.ncbi.nlm.nih.gov/articles/PMC12112870/Capacity-design case (Penn Medicine / HAP May 2025).
Shows impact of daily flow councils and cohorting.
https://www.haponline.org/Portals/1/docs/Events-and-Education/2025-Leadership-Summit/6WoodHAP5122025.pdf
2. Quality Metrics to Share with Your Team
Median hospital operating margin (Aug 2025): ≈ 1.7 %.
FY 2026 IPPS payment increase ≈ $5 B nationwide — local impact varies by case-mix/wage index.
ED boarding reduces transfer acceptance ~ 29 %.
U.S. hospitals shed ≈ 30 000 beds (2019-2022); demand up 5-10 % projected.
Discharge-by-noon goal = ≥ 30 % of daily discharges → shorter ED LOS.
Winter boarding peaks (2024 data): 35 % ≥ 4 hr hold; 5 % ≥ 24 hr.
AHRQ QI v2026 software refresh now active → update dashboards.
3. Leadership Call to Action
Run an October margin reality check using Kaufman Hall benchmarks; flag variances > 1 pp below median.
Have finance model FY 2026 IPPS impacts by service line before November budgets.
Establish a daily 10 AM capacity huddle tracking discharge-by-noon %, ED boarding hrs, and placement delays.
Implement 2 ACEP throughput tactics (rapid-admit unit, inpatient-ready criteria, or virtual bed board).
Assign Quality/Risk to monitor transfers declined due to boarding as a patient-safety metric.
4. Permanent Footer
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