The Latest
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Telehealth laws inhibit widespread use in Medicare population, CMS says
The agency is opening up virtual care in some alternative payment models, but use among fee-for-service beneficiaries is just 0.25%, according to a new report. The states with the highest use are Texas, Iowa and California.
Health IT -
A bit more price transparency is coming to hospitals. Will it matter? #USNHoT
Tom Miller, chief medical officer at University of Utah Health, said the mandate starts a national conversation on why costs are "so dang high" and what can be done about it.
Hospital Administration -
Atrium Health agrees to stop anti-steering practices
The case involves a relatively new target for the Justice Department — restrictions imposed by providers to limit payers from moving patients to high-quality providers.
Payer -
SponsoredMitigating waste in healthcare/provider information exchanges
The data-driven environment has the opportunity to revolutionize healthcare/provider information exchanges.
Payer -
Acute care profitability at nonprofits in decline, Fitch says
The credit rating agency has adopted new metrics that may paint a better picture of a hospital's long-term credit strength.
Finance -
Lack of competition leads to higher ACA plan premiums in rural areas
Lower premiums in urban areas are partially related to more competition among plans and providers, according to a new report from the Urban Institute.
Payer -
Blockchain application still in nascent stages for healthcare, report finds
Short-term applications for the technology include back office operations and product traceability, according to CB Insights.
Health IT -
Data confidence remains low, healthcare CIOs report
Dimensional Insight surveyed 85 chief information officers and other senior healthcare IT leaders, asking them to rate how strongly their user populations believe they can trust the data provided to make decisions.
Health IT -
CVS-Aetna merger cleared by California's insurance regulator
The state's reluctant nod came after the entity promised not to increase premiums as a result of acquisition costs. The deal now awaits regulatory approval from four more states and is expected to close by Thanksgiving.
Payer -
House chairman sees 'every indication' that VA's EHR difficulties will continue
"Frankly," Indiana Rep. Jim Banks said, "the more I learn about the EHR program, the more daunting it has become."
Health IT -
Fitch sees nonprofit hospitals as mixed bag in Q3 report
While not-for-profits hospitals led Q3 public finance rating activity, the pace of upgrades and downgrades appears to be leveling off.
Finance -
In rebound, ACA marketplace to offer more payer options in 2019
Despite concerns of more problems in 2018, ACA payers have actually found their footing — and are even enjoying profits now. Centene, Cigna, Oscar Health, Anthem and Wellmark are moving back into the market or expanding to more counties in 2019.
Payer -
ECRI offers tips on managing acute care patients with behavioral health needs
Nearly half of behavioral health events in acute care facilities involve patient violence against others, an ECRI analysis found.
Hospital Administration -
'Stay tuned,' says Azar: CMMI to take a closer look at social determinants of health
It's unclear how the administration will balance tackling social determinants of health and keeping regulatory burden low.
Policy & Regulation -
Geisinger launches opioid-avoiding 'prehabilitative' surgical program
ProvenRecovery is the latest development from the Danville, Pennsylvania-based integrated health system. The program aims to expedite healing and reduce opioid use across 42 surgical procedures.
Hospital Administration -
Express Scripts plans 'Flex' formulary focused on authorized generics
Gilead’s generic versions of its own hepatitis C treatments Epclusa and Harvoni are first on the list for the new formulary, which starts Jan. 1.
Payer -
Microsoft issues open source FHIR, moving deeper into health
The software giant recently upped its stake in healthcare with the announcement of a formal unit, Microsoft Healthcare.
Health IT -
CMS approves Michigan Medicaid drug value-based payment plan
Administrator Seema Verma also previewed forthcoming agency action on protected classes of drugs in Medicare Part D, hinting that CMS plans to further open the space to private negotiation.
Policy & Regulation -
Oscar calls foul over BCBS' exclusive broker policy in Florida
The insurer filed suit against Florida's Blue plan, alleging anti-competitive conduct over broker's sales arrangements with BCBS.
Payer -
Nearly 50K would lose Medicaid under Arkansas work rules: study
Gresham v. Azar seeks to halt the work requirement experiment on grounds it runs counter to Medicaid law and risks the health of Arkansas' most vulnerable citizens.
Payer -
Specialty drugs drive Rx spending increase, Blue Cross says
Insurers under the Blues' umbrella spent about $100 billion on prescription drugs in 2017, making up roughly 20% of plans' overall healthcare spending. That figure is 2% higher than it was in 2016, and has consistently risen since 2010.
Payer -
Hospital acquisition of physician practices driving demand for integrated technology platforms
Integrated delivery network leaders believe aligning hospital and physician IT systems supports value-based care goals, a new Black Book Market Research report shows.
Health IT -
Managed Medicaid plans treat chronic conditions on par with other commercial coverage, AHIP report finds
The payer group looked at data involving patients with asthma, diabetes and mood disorders to see how clinical care compared between Medicaid, commercial insurance and those who are uninsured.
Payer -
Healthcare will outspend all other industries on R&D by 2020, PwC says
Medtronic is among 23 healthcare companies rated "high-leverage innovators" for performance on seven key financial indicators. Top 20 companies include Alphabet, Samsung, Microsoft, Apple, Roche, Novartis and Pfizer.
Health IT -
Over 4.4M patient records breached in Q3, report finds
One breach involving insider wrongdoing took 15 years to come to light.
Health IT