Policy & Regulation
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APM adoption up to 34%, but downside risk slow to catch on
Organizations truly committed to value-based payment need to be willing to put their money where their mouth is, Seth Morris, director of network development at Anthem, said at a summit announcing the findings of a new report.
By Rebecca Pifer • Oct. 23, 2018
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Viagra no more: The changing face of drug ads on TV
Gone are twin bathtubs and little blue pills. Instead, pharma promotions on TV are more likely to feature complex biologics and cancer drugs.
By Ned Pagliarulo • Oct. 23, 2018
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Burnout hurts nurses' ability to meet profession's demands
Because nurses usually have frequent direct interactions with patients, burnout may pose a risk to "patient and organizational outcomes," according to a new white paper from Press Ganey.
By Les Masterson • Oct. 23, 2018
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Q&ACEO Matt Eyles on why AHIP will probably have to change its name
The insurer lobby's leader addresses key issues affecting the industry and the group's evolving role as insurers morph into both provider and payer.
By Samantha Liss • Oct. 23, 2018
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Critics pounce as CMS gives states more leeway to skirt ACA
New guidance on 1332 Medicaid waivers makes it easier for states to use association and short-term health plans that limit coverage for pre-existing conditions.
By Tony Abraham • Oct. 23, 2018
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Hospital execs admit lack of readiness for Ebola in 2014, but defenses improving
Most said they could adequately respond to such an emergency now, but acknowledge they were not ready to handle Ebola cases during the outbreak, according to a report from the HHS Office of Inspector General.
By Les Masterson • Oct. 22, 2018
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CVS-Aetna merger hits snag in New York, clears Connecticut
New York financial regulators want assurances the companies won't raise premiums in the state.
By Meg Bryant • Oct. 22, 2018
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At least 40% of Medicare Advantage plans to offer pop health benefits
Avalere analyzed CMS data on MA coverage for newly allowed benefits including bathroom safety devices, over-the-counter meds and transportation assistance.
By Les Masterson • Oct. 22, 2018
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Doubt cast on value of hospital accreditation in Harvard study
"Given the minimal benefit seen with accreditation in this study, it raises the question of whether our national efforts need to emphasize accreditation as much as they do," researchers said.
By Meg Bryant • Oct. 19, 2018
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Study finds 40% of doctors pessimistic about practice of medicine
This unease includes concern about their practice's financial stability and administrative management, as well as use of EHRs, according to a new Leavitt Partners white paper.
By Les Masterson • Oct. 19, 2018
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Stakeholders call for transparency, ease of use in EHR Reporting Program
In comments, several healthcare organizations requested a centralized clearinghouse of existing health IT comparison resources.
By Meg Bryant • Oct. 18, 2018
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Industry on Medicare ACO plan: too much risk too fast
Some providers warn they'll drop out if CMS finalizes its proposal as is. Others contend the agency is cracking down on the program in an attempt to kill it.
By Tony Abraham • Oct. 18, 2018
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Medicaid expansion doesn't impede care access or cause longer wait times, study finds
A new National Bureau of Economic Research working paper found no change in office visits, number of days between visits, expenditures and wait times after Medicaid expansion.
By Les Masterson • Oct. 18, 2018
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Deep DiveInsurers see broad market opportunities with end-of-life care
"The reimbursement rates are strong and it's a profitable service to be delivering," said Avalere's Dan Mendelson. "Whenever you have that kind of situation you're going to also have speculative buying and desire to grow these markets."
By Rebecca Pifer • Oct. 17, 2018
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#AHIPMMD speakers mull role of government regulation in healthcare
As payers gathered at AHIP's annual conference on Medicare, Medicaid and dual eligibles, hot topics included the promises of Medicare Advantage, the role of the federal government and drug prices.
By Samantha Liss • Oct. 17, 2018
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5 questions on the Trump admin's bid to mandate prices in drug ads
The proposal is expected to face fierce opposition from industry and raises a wide range of legal, political and economic questions.
By Ned Pagliarulo , Andrew Dunn • Oct. 17, 2018
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#AHIPMMD: Verma touts MA growth, blasts Medicare for all
So far, 270 Medicare Advantage plans will offer new benefits allowed for 2019 that include adult day care and meals, the CMS administrator said at the annual payer conference.
By Samantha Liss • Oct. 17, 2018
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GAO study underscores health benefits of Medicaid expansion
Voters in four states will decide on expansion initiatives in the midterm elections next month.
By Meg Bryant • Oct. 16, 2018
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CVS CEO unfazed by Amazon, focused on closing merger, growth
In a speech to the Economic Club of Washington, Larry Merlo said his goal is to not "leave any white space for Amazon to disrupt."
By Rebecca Pifer • Oct. 16, 2018
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Anthem shells out $16M in largest ever HIPAA fine
The settlement will pay for four years of credit monitoring and all other claims, costs and fees for affected members.
By Rebecca Pifer • Oct. 16, 2018
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Aetna settles HIV disclosure investigation for close to $650K
The multistate settlement stems from 2017 mailings that revealed some policyholders' HIV/AIDS or A-fib status.
By Meg Bryant • Oct. 15, 2018
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Confronting pharma, Trump admin seeks price disclosure in drug ads
HHS chief Alex Azar announced the much-anticipated proposal Monday, dismissing a new pledge from trade lobby PhRMA as insufficient.
By Andrew Dunn • Oct. 15, 2018
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Immigration rule change could force millions off Medicaid, report warns
The Trump administration is proposing a change to "public charge" policies that could also lead to higher costs for providers via uncompensated care and more ER visits, according to the Kaiser Family Foundation.
By Les Masterson • Oct. 15, 2018
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States requiring hospitals provide more info on 340B drugs
Most states don't track 340B drug payments after rebates, but gaining that information could ultimately result in a change to reimbursement amounts.
By Les Masterson • Oct. 15, 2018
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Grassley urges FTC to investigate hospital-payer contracts
The Senate Judiciary chairman is concerned that anticompetitive contracts could limit access to affordable care.
By Meg Bryant • Oct. 12, 2018