The Latest
-
Industry on Medicare ACO plan: too much risk too fast
Some providers warn they'll drop out if CMS finalizes its proposal as is. Others contend the agency is cracking down on the program in an attempt to kill it.
Hospital Administration -
#AHIPMMD speakers mull role of government regulation in healthcare
As payers gathered at AHIP's annual conference on Medicare, Medicaid and dual eligibles, hot topics included the promises of Medicare Advantage, the role of the federal government and drug prices.
Payer -
Blue Button 2.0 doubles developers to 1,200, but beneficiary uptake tiny
CMS Administrator Seema Verma said 11 organizations have "production apps" in place using live data.
Health IT -
Medicaid expansion doesn't impede care access or cause longer wait times, study finds
A new National Bureau of Economic Research working paper found no change in office visits, number of days between visits, expenditures and wait times after Medicaid expansion.
Payer -
Hospitals making limited progress toward cost containment, survey shows
Fewer than one in five executives cited cost reductions greater than 5% in any priority area this year, according to Kaufman Hall.
Finance -
Stakeholders call for transparency, ease of use in EHR Reporting Program
In comments, several healthcare organizations requested a centralized clearinghouse of existing health IT comparison resources.
Health IT -
Deep DiveInsurers see broad market opportunities with end-of-life care
"The reimbursement rates are strong and it's a profitable service to be delivering," said Avalere's Dan Mendelson. "Whenever you have that kind of situation you're going to also have speculative buying and desire to grow these markets."
Payer -
Hospital M&A down slightly in Q3
Texas has seen the most activity this year with five deals, including two in the third quarter, according to Kaufman Hall.
Finance -
5 questions on the Trump admin's bid to mandate prices in drug ads
The proposal is expected to face fierce opposition from industry and raises a wide range of legal, political and economic questions.
Policy & Regulation -
Sutter requests competitor pricing data as part of antitrust lawsuit
Hospitals have balked at the request, saying the information is proprietary.
Health Law -
Leapfrog Group to start rating outpatient settings
The nonprofit will collect safety and quality data on ambulatory surgery centers and hospital outpatient surgery departments starting next year.
Payer -
#AHIPMMD: Verma touts MA growth, blasts Medicare for all
So far, 270 Medicare Advantage plans will offer new benefits allowed for 2019 that include adult day care and meals, the CMS administrator said at the annual payer conference.
Payer -
Anthem shells out $16M in largest ever HIPAA fine
The settlement will pay for four years of credit monitoring and all other claims, costs and fees for affected members.
Health IT -
UnitedHealth grows Q3 revenue, eyes 2019 expansion
The country's largest commercial payer picked up 2.8 million members, including more than 500,000 in Medicare Advantage, over the past year.
Payer -
Apple sees role for Watch app in hip, knee replacement recovery
The tech giant and Zimmer Biomet plan to enroll up to 10,000 U.S. patients to study a new app to coordinate care before and after joint replacement surgery.
Health IT -
GAO study underscores health benefits of Medicaid expansion
Voters in four states will decide on expansion initiatives in the midterm elections next month.
Payer -
CVS CEO unfazed by Amazon, focused on closing merger, growth
In a speech to the Economic Club of Washington, Larry Merlo said his goal is to not "leave any white space for Amazon to disrupt."
Payer -
Confronting pharma, Trump admin seeks price disclosure in drug ads
HHS chief Alex Azar announced the much-anticipated proposal Monday, dismissing a new pledge from trade lobby PhRMA as insufficient.
Policy & Regulation -
Deep DiveLong-term care hospitals: Overpaid or underappreciated?
"The costs associated with operating a long-term care hospital are more closely aligned with short-term acute care hospitals, but less expensive," says Susan Maupin, president of The Advisory Group.
Payer -
States requiring hospitals provide more info on 340B drugs
Most states don't track 340B drug payments after rebates, but gaining that information could ultimately result in a change to reimbursement amounts.
Payer -
Immigration rule change could force millions off Medicaid, report warns
The Trump administration is proposing a change to "public charge" policies that could also lead to higher costs for providers via uncompensated care and more ER visits, according to the Kaiser Family Foundation.
Payer -
Aetna settles HIV disclosure investigation for close to $650K
The multistate settlement stems from 2017 mailings that revealed some policyholders' HIV/AIDS or A-fib status.
Payer -
Massachusetts officials attach stiff conditions to Beth Israel-Lahey merger
The requirements follow a report warning the merger could result in a $128.4 million to $170.8 million spending increase for inpatient, outpatient and adult primary care services.
Hospital Administration -
National Academy of Medicine argues barriers to interoperability are organizational, not technical
A report outlining challenges and recommendation for data sharing comes as the industry awaits a rule from HHS that attempts to thwart information blocking.
Health IT -
Average ACA premiums will drop for first time in 2019
Payers put through huge premium increases over the past two years, meaning next year's rates are likely a market correction.
Payer