Medicare overpaid millions for outpatient planning services

A report from the HHS Office of Inspector General blamed the excessive payments for intensity-modulated radiation therapy planning services mostly on hospitals not knowing or misinterpreting CMS guidance.

By Les Masterson • Aug. 21, 2018

UPMC extends revenue boom in H1

Results are the latest in a streak of positive reports for the integrated health system. Executive Vice President Leslie Davis said the Pittsburgh-based company is "running out of room in Pennsylvania."

By Tony Abraham • Aug. 21, 2018

Target hospitals see limited benefits from M&A, report finds

Evidence is mixed, however, on how much acquiring hospitals can save after a deal, according to the National Bureau of Economic Research analysis.

By Rebecca Pifer • Aug. 21, 2018

CEO salaries at nonprofit hospitals up 93% since 2005

Nonprofit hospital CEOs earn three times as much as orthopedic surgeons and seven times what pediatricians make, according to new research.

By Meg Bryant • Aug. 17, 2018

Internet of medical things market to hit $158B by 2022, report predicts

However, more than seven in 10 medtech leaders feel providers are not ready to use the data generated by connected medical devices, the Deloitte analysis shows.

By Meg Bryant • Aug. 16, 2018

Payers transition to government health plans despite risks

Commercial health plans have dropped over the past 10 years as payers move to managed Medicaid and Medicare Advantage.

By Les Masterson • Aug. 16, 2018

Oscar gets $375M investment from Alphabet, eyes MA market in 2020

The payer startup has already expanded beyond its initial offerings in the ACA exchanges and individual market.

By Les Masterson • Aug. 15, 2018

Prior authorization moves to EHRs

Manual prior authorization can create administrative burdens for practices and hospitals, but case studies show some success in making the process electronic.

By Les Masterson • Aug. 15, 2018

5 key takeaways from hospitals' Q2 results

Earnings were mixed for hospital operators in the second quarter, with winners and losers beginning to emerge amid industry uncertainty. 

By Tony Abraham , Rebecca Pifer • Aug. 15, 2018

Global EHR market on track to top $39B by 2022

Among the factors driving growth are system upgrades and vendor switches, according to a new Kalorama Research report.

By Meg Bryant • Aug. 14, 2018

Nearly 20% of inpatient admissions include out-of-network charge

A Kaiser Family Foundation report found the issue of surprise billing is especially problematic for care in ERs and for psychological or substance abuse treatment.

By Les Masterson • Aug. 14, 2018

Icahn raises white flag in Cigna-Express Scripts tiff

Activist investor Carl Icahn has relinquished his fight to block Cigna's acquisition of Express Scripts after two high-profile advisory firms backed the deal.

By Tony Abraham • Aug. 14, 2018

AHA continues to push HHS on Medicare billing backlog

AHA and three member hospitals are suing the agency and in the latest court filing suggested methods for reaching a court-ordered 2020 deadline for getting through the claims.

By Les Masterson • Aug. 14, 2018

Quorum eyes up to $215M from asset sales as net loss grows

The Brentwood, Tennessee-based company's operating revenue declined 9% to $959.9 million in H1 2018.

By Meg Bryant • Aug. 10, 2018

More than 20% of Americans skip medical care due to cost, survey finds

More than half of respondents said they are very or somewhat concerned that they may not have affordable health insurance in the future.

By Meg Bryant • Aug. 10, 2018

Cigna wins Texas underpaid claims lawsuit

North Cypress Medical Center charged that the payer owed $50 million in unpaid claims, but Cigna said the hospitals's fee-forgiving policy for out-of-network care is illegal.

By Les Masterson • Aug. 10, 2018

Scripps net income takes huge hit despite strong revenue growth

The San Diego-based nonprofit said operating revenue growth was fueled by gains in patient volumes, outpatient visits and larger provider fee revenue.

By Meg Bryant • Aug. 9, 2018

AMA charges CVS-Aetna deal would reduce competition

The analysis came as Bloomberg reported that the Justice Department won't oppose the merger based on vertical competition issues, although it may still be looking at how it will affect the pharmacy market.

By Les Masterson • Aug. 9, 2018

Academic medical centers lag behind other facilities for cost, quality

Despite improvements on some metrics, AMCs still face more Medicare value-based program penalties, according to a Navigant report.

By Les Masterson • Aug. 9, 2018

Small company employees with high-deductible plans get less help with out-of-pocket costs

More than three-fourths of HDHP members in small companies don't have an employer-funded account, according to a study from researchers at the Agency for Healthcare Research and Quality.

By Les Masterson • Aug. 8, 2018

5 takeaways from payer Q2 earnings reports

Health insurers found success in Medicare, Medicaid and even the ACA exchanges.

By Les Masterson • Aug. 8, 2018

Cigna claps back at Icahn in defense of Express Scripts acquisition

In a lengthy letter to shareholders, Cigna claims activist investor Carl Icahn's disapproval of its pending deal with Express Scripts is "misguided and short-sighted." Shareholders will vote on the deal Aug. 24.

By Tony Abraham • Aug. 8, 2018

Fitch brightens its view on nonprofit hospitals

More than a quarter of facilities got upgrades in the latest review of issuers.

By Les Masterson • Aug. 8, 2018

Tenet beats expectations despite dip in admissions, revenue

The Dallas-based hospital operator reported a decrease in net operating revenues and admissions for Q2 but posted increases in net patient revenues and ambulatory segment revenue.

By Tony Abraham • Aug. 7, 2018

Icahn blasts Cigna-Express Scripts deal as among 'worst acquisitions in corporate history'

The activist investor warned that PBMs are under a political microscope too risky for Cigna investors, also citing risks from Amazon. Shareholders vote on the deal Aug. 24.

By David Lim • Aug. 7, 2018