Finances: Page 33
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Feds brokered record $5B in healthcare fraud cases last year
Cases ranged from improper psychiatric treatment to providing false Medicare claims and illegal kickback schemes.
By Rebecca Pifer Parduhn • July 6, 2022 -
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UHS lowers financial outlook on 'unfavorable' operating environment, making good on April warning
UHS is not the first system to slash guidance this year citing adverse operating conditions, trailing peers HCA and CHS.
By Rebecca Pifer Parduhn • June 30, 2022 -
Health services M&A slowed in Q1, but rebound anticipated
Private equity and corporate funding remains available and is driving competition for assets, especially for physician medical groups, home health organizations and long-term care facilities.
By Susan Kelly • June 27, 2022 -
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Inequities in healthcare cost nearly $320B annually, new research shows
Spending due to inequities that drive late diagnoses and comorbidities is only expected to rise over the next few decades without intervention, according to research from Deloitte.
By Hailey Mensik • June 22, 2022 -
Finances of older Americans being dinged by high health costs, survey finds
It’s the latest picture of how exorbitant healthcare costs in the U.S. are increasingly impacting the financial stability of Americans, especially older adults.
By Rebecca Pifer Parduhn • June 15, 2022 -
Most Medicare Advantage enrollees like their plans, survey finds
As the program has soared in popularity, it has attracted the attention of federal investigators, including an HHS OIG report finding inappropriate prior authorization and claims denials.
By Susan Kelly • June 14, 2022 -
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Deep DiveDespite rosier trust fund outlook, time running out to stabilize Medicare funding, researchers warn
Though it’s tempting to interpret the recent Medicare trustees report as good news, academics are arguing lawmakers can’t wait until hospital trust fund insolvency is imminent before taking action to bolster the program.
By Rebecca Pifer Parduhn • June 13, 2022 -
Oracle closes $28B buy of 'huge growth engine' Cerner
With the deal’s close, the days of standalone EHR vendors are increasingly in the rearview mirror.
By Rebecca Pifer Parduhn • June 8, 2022 -
Carol Highsmith. (2005). "Apex Bldg." [Photo]. Retrieved from Wikimedia Commons.
FTC launches investigation into PBMs; CVS, UnitedHealth, Cigna and more hit with requests for data
Pharmacy groups cheered the news, which reversed a vote earlier this year by FTC commissioners not to investigate PBMs' pricing and contractual practices.
By Rebecca Pifer Parduhn • June 7, 2022 -
Courtesy of Teladoc
Teladoc hit with class-action suit alleging it misled investors
The complaint accuses the company, along with CEO Jason Gorevic and CFO Mala Murphy, of downplaying competition that stifled growth in Teladoc's mental health and chronic care businesses.
By Rebecca Pifer Parduhn • June 6, 2022 -
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Payers to return $1B to enrollees after record years of rebates, KFF says
The amount reflects the third-straight year of large insurer rebates as payers experienced high profits from the COVID-19 pandemic.
By Sydney Halleman • June 3, 2022 -
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Trustees' report shows additional breathing room for Medicare solvency, though concerns remain
Stronger-than-expected economic recovery from COVID-19 pushed back Medicare's go-broke date by two years, though budget hawks are warning the sunnier outlook might rely on outdated assumptions.
By Rebecca Pifer Parduhn • June 3, 2022 -
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Steep expenses, falling patient volumes stifled hospitals in April
Kaufman Hall's new findings reverse trends from March, when hospitals posted a modest rise in patient volumes and temporary expense reliefs.
By Sydney Halleman • June 1, 2022 -
PBM practices are keeping consumers from generics savings, white paper finds
Consumers are overpaying for generic drug prescriptions by as much as 20% due to pharmacy benefit manager practices like copay clawbacks and spread pricing, researchers found.
By Rebecca Pifer Parduhn • June 1, 2022 -
Cleveland Clinic, scrambling to staff hospitals, posts Q1 loss
The academic medical giant is paying higher employee wages and hiring more agency nurses and other temporary personnel to cope with a nationwide shortage of healthcare workers.
By Susan Kelly • May 31, 2022 -
Change shares peek at 2023 as UnitedHealth merger trial looms
The data analytics company highlighted its momentum heading into the next fiscal year, outlining what 2023 could look like if its controversial $13 billion merger with UnitedHealth falls through.
By Rebecca Pifer Parduhn • May 31, 2022 -
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Healthcare spending could drop $11.4B next year if ACA premium subsidies expire, research finds
The looming coverage cliff would also hit providers financially, according to a new report. President Joe Biden has pushed Congress to extend the more generous financial aid provided by the American Rescue Plan.
By Rebecca Pifer Parduhn • May 26, 2022 -
AHA urges DOJ to probe Medicare Advantage plans that deny care
The hospital lobby is pushing the Justice Department to punish Medicare Advantage organizations that routinely deny coverage to beneficiaries.
By Susan Kelly • May 23, 2022 -
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Hospitals charge employer health plans more than 2 times what they charge Medicare for same services
Rand researchers also found wide price variations across states. Florida, West Virginia and South Carolina had relative prices at or above 310% of Medicare prices, according to the report.
By Hailey Mensik • May 18, 2022 -
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Nonprofit hospitals squeezed by pricier labor, investment losses in Q1
The first quarter is going to be "one of the worst for most of our providers," Fitch Analyst Kevin Holloran said last week.
By Samantha Liss • May 16, 2022 -
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Hospital labor expenses up 37% from pre-pandemic levels in March
Hospitals spent nearly $5,500 in labor expenses per adjusted discharge in March compared to about $4,000 roughly three years ago, according to a report from Kaufman Hall.
By Hailey Mensik • May 12, 2022 -
Courtesy of Oscar Health
Oscar Health withdraws from 2 states
Leaving Arkansas and Colorado won't have a material effect on the company's income, and should reduce the insurtech's overhead in areas like compliance work and statutory reporting, executives said.
By Rebecca Pifer Parduhn • May 11, 2022 -
Amwell Q1 net loss widens on costs to expand Converge platform
The vendor's revenue grew 11% while expenses climbed 40% year over year, as Amwell invested heavily in research and development for its open architecture Converge platform.
By Rebecca Pifer Parduhn • May 10, 2022 -
Insurers saw profits rise in Q1 as cost increases weighed on hospitals
The results spurred payers to paint an improved financial outlook for the full year compared to earlier estimates for 2022.
By Samantha Liss • May 9, 2022 -
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Mass General Brigham gets partial nod for $2B expansion
Massachusetts' leading hospital system, under state scrutiny to rein in spending, has cleared a key hurdle in its expansion plans.
By Susan Kelly • May 9, 2022
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