Policy & Regulation
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Trump admin pitches sweeping plan to reorganize HHS, government
Among the proposals is creation of a permanent “Council on Public Assistance" with authority to set uniform work requirements across Medicaid and other programs. Congress must sign off on most of the ideas.
By David Lim , Tony Abraham • June 22, 2018
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Oscar Health expanding ACA marketplace footprint
The health insurance company plans to grow to nine states in 2019.
By Les Masterson • June 21, 2018
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CMS seeks input on Stark Law changes amid value-based care shift
The American Hospital Association has been vocal in pushing for changes to the physician self-referral law, calling it outdated.
By David Lim • June 21, 2018
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Opioid supply levels decline in most states, report finds
States that passed laws to limit opioid prescriptions, such as Maine, appeared to have the biggest reductions.
By Suzanne Elvidge • June 21, 2018
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FDA unveils software Pre-Cert update
The agency hopes to finalize the working model by the end of the year and launch a large-scale pilot program in 2019.
By Meg Bryant • June 21, 2018
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Deep DiveHospital CEO pay rises steadily, but still lags many sectors
Median CEO pay at hospital and health systems is stable with very modest increases in the range of 2.5% to 3% year-over-year.
By Les Masterson • June 20, 2018
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AMA opposes CVS-Aetna deal
Company officials argued the deal could reduce healthcare spending, improve efficiencies and help patients with chronic illnesses, but the AMA said less healthcare competition would be bad for consumers.
By Les Masterson • June 20, 2018
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Deductibles, coinsurance on the rise, but cost of copays are down
A new Peterson-Kaiser Health System Tracker report on large employer health plans also found that insurers are paying slightly less on covered medical expenses than a decade ago.
By Les Masterson • June 20, 2018
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Trump admin finalizes Association Health Plans expansion
The final rule appears to contain protections for pre-existing conditions, age and gender, but allows AHPs to skirt the ACA's 10 essential health benefits.
By David Lim • UPDATED: June 20, 2018 at 10:05 a.m.
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340B audit imbalances under fire at Senate panel
The director of the agency overseeing the drug discount program for hospitals said legislation is needed for it to do a better job at oversight and transparency.
By Tony Abraham • June 19, 2018
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Patients want better communication, care coordination, survey shows
Insurance giant Aetna finds physician respondents working within value-based care models have better access to community resources.
By Les Masterson • June 19, 2018
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Hospitals to lose $218B in federal payments by 2028, study predicts
The Federation of American Hospitals and the American Hospital Association commissioned a report to look at how 11 pieces of legislation, combined with regulatory changes, are affecting hospital reimbursement.
By Les Masterson • June 18, 2018
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MedPAC recommends quality measure consolidation
In its June report, the Medicare Payment Advisory Commission also refined its previous suggestions for freestanding emergency department payments.
By Tony Abraham • June 18, 2018
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Payers moving to value-based care faster than expected
Insurers can take a while to implement programs, however, with 21% needing 18 months and 13% requiring up to two years or more, according to a survey from Change Healthcare.
By Les Masterson • June 18, 2018
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Chicago health system says hospital star ratings not accurate
Rush University Medical Center researchers said CMS unfairly relied too much on some measures in its ratings program.
By Les Masterson • June 18, 2018
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Deep DiveFight for mandated nurse-to-patient ratios heats up
Nurses point to research suggesting mandatory staffing ratios in California helped improve patient health outcomes. The hospital industry, however, remains resistant, citing staff shortages and other roadblocks.
By Tony Abraham • June 15, 2018
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Leapfrog pans CMS rule rolling back some quality reporting measures
The group that advocates for hospital quality said the change to the Inpatient Quality Reporting Program would be a blow to transparency and would reduce penalties for errors and infections.
By Les Masterson • June 15, 2018
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Fitch says Medicaid cost growth likely to force states to cut programs
The ratings agency reported that healthcare costs for states have increased more than $300 billion since 2005, and will only grow in the next decade.
By Les Masterson • June 14, 2018
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Healthcare megadeals seen as more likely after media merger ruling
Most see promise in the parallels with the AT&T-Time Warner decision letting a vertical merger go forward and the pending CVS-Aetna and Cigna-Express Scripts pacts.
By Tony Abraham • June 14, 2018
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Federal appeals court denies insurers billions in risk corridor payments
In the lawsuit brought by Moda Health, the court ruled the program "lacks the trappings of a contractual agreement."
By Tony Abraham • June 14, 2018
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Loosening scope of practice rules could improve care and costs, report argues
Two healthcare economists suggested cutting policies that mandate supervisory and formal collaborative practice agreements.
By Les Masterson • June 14, 2018
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Medigap plans rise in popularity but coverage geographically sparse, AHIP says
A new report from the insurance lobby found more than 13 million beneficiaries have a Medigap plan.
By Les Masterson • June 13, 2018
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Deep DiveNew Medicare Advantage rules hold big potential for pop health
A CMS rule taking effect this week lets payers offer benefits like ride-hailing and nutrition support to boost health.
By Meg Bryant • June 13, 2018
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CMS again postpones hospital star ratings update
Providers have been wary of report cards, and hospital groups lauded the agency's decision to delay the update.
By Tony Abraham • June 13, 2018
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FDA mulls new incentives to stem antimicrobial resistance
The agency is working on smoother approval pathways for new products and proposing new reimbursement models to account for limited use.
By Suzanne Elvidge • June 13, 2018