Aetna sells Medicare Part D business to WellCare subsidiary

The deal is meant to grease the wheels for approval of the payer's pending $69 billion acquisition by CVS.

By Samantha Liss • Sept. 27, 2018

Safety-net hospitals get break on FY19 readmission penalties, analysis finds

Some penalties are being cut by half or more, and 65 safety-net facilities that were penalized last year will see no dock at all this year, according to a data review by Kaiser Health News.

By Les Masterson • Sept. 27, 2018

UnitedHealthcare threatens to drop Envision providers

Envision, which employs more than 23,000 clinicians, said it is preparing to continue to serve patients and hospitals "without disruption regardless of the contract status with any payer."

By Les Masterson • Sept. 26, 2018

Hospital leaders see little relief from rising labor budgets, survey shows

To cut expenses, executives will focus on labor costs and supply chain productivity, according to a report from the Healthcare Financial Management Association and Navigant.

By Meg Bryant • Sept. 25, 2018

Medicaid spending increase expected to exceed GDP growth over next decade

A new HHS Office of the Actuary report projected an average annual rate increase of 5.7% until 2026.

By Les Masterson • Sept. 24, 2018

Nonprofit hospital operating margins struggle despite stronger balance sheets, Fitch says

The median rating remains an A, with hospitals showing improvement in all key balance sheet metrics, according to the ratings agency.

By Meg Bryant • Sept. 21, 2018

Iowa's Medicaid managed care costs rise faster than before

Medicaid per-member costs increased an average of 4.4% in the first full year of privatization. That's nearly triple the 1.5% average the previous six years.

By Les Masterson • Sept. 21, 2018

Oklahoma hospital turns to go GoFundMe to stay afloat

After a fallout with a previous management group and a legal battle over cash, a rural hospital is on the brink of closing.

By Samantha Liss • Sept. 20, 2018

Prescriptions, ED visits, outpatient services drive healthcare spending growth

The Health Care Cost Institute found that employer-sponsored insurance spending increased by 44% between 2007 and 2016.

By Les Masterson • Sept. 20, 2018

Athenahealth extends acquisition bid deadline

The delay is to allow for a new strategic buyer to prepare its bid, a source close to the matter said.

By Meg Bryant • Sept. 19, 2018

Medicare ACOs save more money with more time, Avalere says

The Medicare Shared Savings Program has been scrutinized recently as more performance data surface. After the initiative missed federal cost savings projections from 2013 to 2016, recent results have been more promising.

By Les Masterson • Sept. 19, 2018

Summa Health pulls off financial turnaround in H1

The system's interim CEO said a broad effort to lower costs and improve access was responsible for the favorable first half, including expanded hours and moving to a new headquarters.

By Les Masterson • Sept. 18, 2018

Cigna-Express Scripts merger cleared by DOJ

Federal regulators said the deal "is unlikely to result in harm to competition or consumers." Eyes now turn to the proposed Aetna-CVS union.

By Samantha Liss • Sept. 17, 2018

Patient attribution crucial part of value-based contracting, actuaries say

There are trade-offs between attribution methods that rely on retrospective reviews of fee-for-service claims and those that attribute patients in advance of performance periods, according to a Society of Actuaries report.

By Les Masterson • Sept. 17, 2018

Hospital operating margins dropped 39% over 3 years

Lower demand, Medicare payments and collection rates, as well as the move to value-based contracting, led to the decrease, according to a Navigant report.

By Les Masterson • Sept. 13, 2018

Evolent buys New Century Health to beef up specialty care

The value-based care services company is looking to expand its influence over costs and move into Medicare Advantage, a high-growth area.

By Les Masterson • Sept. 13, 2018

Managed care companies, providers would benefit from Medicaid expansion

Four states with ballot initiatives this fall to expand Medicaid could boost bottom lines of big-name payers and health systems, according to a new report.

By Les Masterson • Sept. 12, 2018

Calls for more transparency after Memorial Sloan controversy

Renowned breast cancer researcher José Baselga, also CMO at Memorial Sloan Kettering, accepted millions of dollars from companies but failed to reveal those payments in published research.

By Meg Bryant • Sept. 11, 2018

Mayo Clinic plans $800M expansion in Arizona, Florida

The health system will roughly double the size of its Phoenix campus with added clinical space and infrastructure. Over the next 10 years, the project will add 2,000 new jobs, including 200 physicians.

By Meg Bryant • Sept. 7, 2018

Life science CEOs see future in technology, disruption

A KPMG survey also showed that cybersecurity remains a major pain point, with 33% of executives calling it the top risk to their organization's growth.

By Meg Bryant • Sept. 6, 2018

Physician-led ACOs saw savings in Medicare program

Hospital-integrated ACOs, however, didn't have the same success, according to a study published in the New England Journal of Medicine.

By Les Masterson • Sept. 6, 2018

Ascension exits Northwest with sale of Washington hospital

The largest Catholic health system in the country has completed the sale of Lourdes Health Network to Brentwood, Tennessee-based RCCH HealthCare Partners, a for-profit firm.

By Samantha Liss • Sept. 6, 2018

More patients sidestepping ED for low-acuity problems

Despite growing use of lower-cost care options, spending for low-acuity conditions rose 14% between 2008 and 2015, according to a report published in JAMA Internal Medicine.

By Meg Bryant • Sept. 6, 2018

JAMA studies show upsides of CMS bundled payment models

The reports found reduced institutional post-acute discharges with the CJR program and no increase in patient volume for the BPCI model.

By Les Masterson • Sept. 6, 2018

HCA to buy North Carolina health system for $1.5B

The proposed sale, first announced in March, was met with concern by some in the state worried that for-profit ownership would result in closed facilities and less access to care for rural areas.

By Les Masterson • Sept. 4, 2018