Finances: Page 140
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Are Medicare Advantage plans being overpaid by billions?
Another study says "yes," blaming unjustifiably high risk scoring for plan members — but the industry fires back. Is the increase in risk scores due to MA plans' aggressive billing or a sicker patient population?
By Judy Packer-Tursman • June 5, 2014 -
Medicaid expansion boosts some hospitals' revenue
And the numbers are striking. One hospital in Seattle expects to see an additional $20 million this year alone — double its initial projection.
By Judy Packer-Tursman • June 4, 2014 -
Medicare to cover hepatitis C screening, but not in the hospital
With 17,000 Americans infected annually, CMS wants to protect adults from the virus — if they go to the right care setting.
By Judy Packer-Tursman • June 4, 2014 -
Medicare Advantage bids hint at 2015 changes
Health plans submitting Medicare bids by the June 2 deadline faced tough choices, and the result is shrinking provider networks, premium hikes and benefit cuts.
By Judy Packer-Tursman • June 3, 2014 -
CMS updates Medicare hospital charge data
The update is part of a suite of new data products released in the name of transparency — but will they be useful?
By Katie Bo Williams • June 3, 2014 -
AmSurg to purchase Sheridan Healthcare for $2.35B
The combined company will include more than 4,600 physician relationships in 38 states — and may reflect the future of health care M&A in 2014.
By Katie Bo Williams • May 30, 2014 -
Upcoding to blame for $6.7B in Medicare overpayments?
The OIG concluded that 26% of 2010 claims reflected a higher level of severity than what was justified by the patient's record, indicating a widespread (and very expensive) problem.
By Anne Zieger • May 30, 2014 -
How hospitals should handle the rise in commercial audits
Providers are dealing with the rising number of audits not just from RACs, but also commercial health plans — and these kinds of assessments are very different than Medicare audits.
By Anne Zieger • May 28, 2014 -
Hospitals experiment with new charity care policies under ACA
Providers are struggling with questions of patient eligibility for insurance and whether they should grant charity care at all.
By Anne Zieger • May 28, 2014 -
Hospitals cutting back on charity care
Not-for-profit providers are adopting new tactics, such as charging the uninsured copayments, but the jury is out on whether this will nudge patients to obtain insurance.
By Anne Zieger • May 27, 2014 -
Health care M&A deal value up dramatically
...but the pace of deals remained the same as 2013. Is the market slowing down, or are larger deals becoming more commonplace?
By Anne Zieger • May 27, 2014 -
Report: Hospital deals down but value rises
...and the trend is likely to go on this year, as ACA-driven changes continue to impact the industry.
By Randy Lilleston • May 23, 2014 -
Deep Dive
Why insurers have no choice but to hire retail execs
"Patients" are no longer "patients" — they're "consumers." And as a result, payers have to think less like insurers, and more like ... bankers?
By Katie Bo Williams • May 21, 2014 -
Fitch says hospital-employer contracts will increase
The firm admits, however, that the short- and long-term financial implications of these arrangements aren't clear.
By Anne Zieger • May 21, 2014 -
Major retailers, hospital chains strengthen ties
Wal-Mart, big drugstore chains, and even some grocery chains are cutting deals with health care systems to take advantage of increased demand as more Americans obtain health insurance.
By Randy Lilleston • May 19, 2014 -
Hospitals seek ways to attract affluent immigrants
Language interpreters, more menu options and foreign-language TV are among the options available at some hospitals, which are looking for ways to attract an increasingly diverse and prosperous patient base.
By Randy Lilleston • May 19, 2014 -
Deep Dive
How one insurer exposed Medicare ACOs' biggest flaw
Universal American has announced it will no longer fund unprofitable Medicare ACOs, highlighting the biggest weakness in the ACO model in the process. Is this the beginning of a trend?
By Katie Bo Williams • May 16, 2014 -
Hospital CEO turnover: A symptom of a greater sickness?
Last year set a record for carnage among top hospital executives, according to a recent survey. It's past time to think about the effects of that turnover.
By Anne Zieger • May 15, 2014 -
ACA may help some publicly traded hospitals boost profits
Community Health Systems saw fewer self-pay admissions in states that expanded Medicaid under the ACA.
By Anne Zieger • May 9, 2014 -
Deep Dive
Rural health care: efficient, safe and a lot cheaper
Despite an ongoing "rural health crisis" that has resulted in closures across the nation, rural hospitals are on average less expensive and more efficient than their urban counterparts. Healthcare Dive took a trip to an isolated town in the mountains of eastern Tennessee to find out why.
By Katie Bo Williams • May 8, 2014 -
Hospital M&A deal volume fell in 2013
Despite the drop in year-over-year volume, the number of hospitals and hospital beds involved in transactions hit a five-year high.
By Anne Zieger • May 8, 2014 -
The 5% solution and why it might ease hospitals' pain
Setting a minimum charity care standard might be good for everyone involved, especially if it's paired with a clear definition of 'charity care.'
By Anne Zieger • May 7, 2014 -
Report: Health care access, affordability declined in recent years
Over the last five years and across states, quality and access of health care care actually declined among adults younger than 65.
By Anne Zieger • May 1, 2014 -
Health care spending rises 9.9% in three months
According to a report from the Bureau of Economic Analysis, the spike was largely driven by the use of more health services, prescriptions for higher-priced drugs and elective surgeries.
By Anne Zieger • May 1, 2014 -
Cigna Q1 profit shoots upward
First quarter net income rose more than 800% while revenue climbed 3.8%, an increase CIGNA attributes to growth in premiums and fees.
By Anne Zieger • May 1, 2014
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