The Latest
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Dual eligible MA beneficiaries receive better care at lower costs than FFS
Dual eligibles in MA plans also received more preventive care and had significantly lower rates of health complications than those in traditional Medicare, according to an analysis from consulting firm Avalere.
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No improvement in patient access to online health records, ONC finds
Patients' reasons for not using online records were mostly unchanged from 2017 to 2018, although fewer people cited privacy concerns or lack of website access.
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SponsoredHow 5 health plans are using social determinants of health data to improve health outcomes
There is growing recognition that social determinants of health data are a central piece of the puzzle for the U.S. healthcare system.
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Private payers cover more than 40% of drug costs
Patients pay 14% of overall retail drug spend in the U.S. in the form of out-of-pocket costs, according to a new analysis from the Kaiser Family Foundation.
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Healthcare spending accelerated in Q1, Altarum finds
A new report shows healthcare prices are growing more slowly than the prices of all other goods, continuing a 20-month trend.
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5 state AGs push judge to approve CVS-Aetna merger agreement
The states originally opposed the deal but said they are satisfied with the current merger agreement.
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JP Morgan expands footprint in healthcare payment game
Philadelphia-based InstaMed, the financial giant's new acquisition, is particularly focused on eliminating paper from the labyrinthine healthcare payments system.
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Gilead CEO pressured on PrEP pricing at House hearing
Critics of Gilead contend it had little to do with the research behind Truvada's use as a preventive therapy — a charge CEO Daniel O'Day rebutted.
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Wyden introduces price transparency bill targeting payers
The legislation stipulates that commercial insurers, as well as Medicare plans, provide an online tool and toll-free phone number for members to ask about cost of services and quality of providers.
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CMS pulls back on key Part D proposals
While the final rule is seen as a win for pharmas and insurers, pharmacists and drugstores were not pleased.
UPDATED: May 20, 2019 at 8:41 a.m. -
Small PBMs urge Congress: Don't kill rebates
An HHS rule that would eliminate Medicare and Medicaid drug rebates could have the unintended effect of raising patients' drug costs, one executive said.
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Express Scripts plans formulary for apps, medical devices
A list of digital health tools, including smartphone apps and software-enabled medical devices, is aimed at helping patients manage their health.
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CMS targets PBM spread pricing
The agency is concerned the practice of charging pharmacists and health plans different prices for the same drugs is inflating costs and increasing the burden on taxpayers.
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Patients aren't sold on virtual health benefits, payers find
Health plans have been quick to embrace virtual care despite issues surrounding outcomes and access. A new survey from AHIP found most payers are facing unexpected challenges with patient adoption of virtual care.
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Provider demand for accurate patient matching is high, Pew says
Providers vary in how bad they think the country's patient matching problem truly is, with a majority indicating they don't have a "significant" problem with correctly matching records to patients.
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About 1/3 of hospitals earn A grade on safety, Leapfrog says
Patients at low-performing hospitals as graded by Leapfrog face a 92% greater risk of avoidable death, according to the report.
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Deep DiveOn the path to patients, NASH drugs may hit a payer roadblock
Wall Street estimates and clinical data suggest the earliest NASH drugs could come with limited efficacy but high price tags. Healthcare providers fear that won't sit well with payers.
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Physician revenues have jumped 52% since 2016
Cardiologists, neurosurgeons and orthopaedic and cardiovascular surgeons are the highest revenue-generators among their peers, each netting more than $3 million a year for their hospitals, according to a Merritt Hawkins survey.
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FTC commissioner: M&A outpacing agency funding
The regulator and other enforcers face multiple challenges in bringing enforcement actions against hospitals, FTC Commissioner Rebecca Kelly Slaughter said.
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Nonprofit hospitals on solid footing to handle outside disruption, S&P says
The sector has been "heavily resilient," mostly due to strong management and governance over the past 20 years, according to a new report.
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Federal lawmakers put forward competing proposals to ban surprise billing, with key difference
Both bills are bipartisan, but a draft bill in the House does not include arbitration, while the Senate plan does. The American Hospital Association supports such a provision, while the payer lobby group strictly opposes it.
UPDATED: May 16, 2019 at 8:47 a.m. -
In US-China tariff poker game, health supply chains stand to lose
Tariffs on medical equipment and supplies, plus duties on imported steel and aluminum, could result in millions of increased costs for the healthcare industry and U.S. patients.
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As Trump wades in, states move on surprise billing
The political climate in Washington, where even historically bipartisan efforts move slowly at best, has left states to step in and do what they can.
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DOJ loses fight to limit CVS-Aetna testimony
The judge said it is "essential" to understand how pharmacy benefit management services affect Medicare Part D drug plans, which make up the scope of the merger settlement agreement.
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SponsoredAn empowering approach for behavioral healthcare providers
The behavioral health crisis in the United States is putting increased pressure on an already strained system, overwhelming providers and impacting care delivery in our nation’s emergency departments.
