Finances: Page 141
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HHS allows new delay for some SHOP exchanges
Small businesses 'employee choice' option on health plans will wait until 2015 in 18 states with federally facilitated SHOP exchanges. The implications for hospitals remain unclear.
By Judy Packer-Tursman • June 11, 2014 -
Mercy Health System to lay off 300 across four states
The hospital blames the layoffs on state-level refusal to expand Medicaid, indicating that even large systems are not immune to the impact of recalcitrant legislatures.
By Katie Bo Williams • June 10, 2014 -
AMA pushes for physician-led care models
Doctors want to take charge of health-care delivery, leading teams serving primary-care needs through value-based care models such as ACOs. Where does this leave hospitals in the fast-changing market?
By Judy Packer-Tursman • June 10, 2014 -
Hospitals see surge of ER patients under reform
Medicaid expansion was intended shift the newly insured into primary care and away from the ER, but in some states, the opposite is happening. What factors are playing into this unexpected situation, and how can it be corrected?
By Judy Packer-Tursman • June 10, 2014 -
VA audit reveals 57,000 vets await appointments
But does the audit show the full extent of systemic problems? How much will VA's outlined emergency fixes actually help?
By Judy Packer-Tursman • June 9, 2014 -
Deep Dive
The Highmark Health gamble: How risky is insurer-hospital integration?
After purchasing a Pennsylvania health system, Highmark Health posted a $186 million loss in 2013 and may lose the leading area provider from its network. What happens next, and what does the Highmark story mean for the trend of vertical integration?
By Judy Packer-Tursman • June 9, 2014 -
Health care doubles average monthly job growth in May
Economic indicators point to a good start to 2014 for the hospital sector. Will the good news continue?
By Judy Packer-Tursman • June 6, 2014 -
Are hospitals that buy oncology practices grabbing extra profits?
A report says hospitals buying oncology practices have increased their purchases through a federal drug discount program meant for low income Americans — with almost half of such hospitals pocketing savings.
By Judy Packer-Tursman • June 6, 2014 -
Why consumers are ignoring health cost data
The industry push for transparency is based on the theory that high deductibles will drive patients to get more involved in health pricing and quality... but that may be a false assumption.
By Anne Zieger • June 5, 2014 -
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
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