Policy & Regulation
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Potential Medicare APM overlap an increasing concern
Competing payment models in the same area "may have far-reaching impact on provider incentives and behavior," the authors of a recent Health Affairs blog post said.
By Les Masterson • April 19, 2018
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Illinois stops Medicaid enrollment to state's BCBS
The state sanctioned the payer’s Medicaid managed care plan after it reportedly didn't meet patient access guidelines.
By Les Masterson • April 19, 2018
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Healthcare megadeals may have major long-term impact, Moody's says
Payer vertical integration could put more pressure on hospital volumes and margins, according to a new report.
By Les Masterson • April 18, 2018
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FDA targets medical device safety in new plan
The plan includes integrating the device center's premarket and postmarket offices.
By Meg Bryant • April 18, 2018
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ACP says dozens of MIPS quality measures are not valid
The American College of Physicians has joined other prominent groups in questioning the positive impact of the Merit-based Incentive Payment System track under MACRA.
By Tony Abraham • April 18, 2018
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3 states could have Medicaid expansion on the ballot
Meanwhile, Arizona is requesting a waiver to stop Medicaid recipients from getting retroactive coverage up to three months before a person applies for coverage.
By Les Masterson • April 18, 2018
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Healthcare sharing ministries: 5 things to know
These alternatives to regular health insurance have grown to nearly 1 million people this decade.
By Les Masterson • April 18, 2018
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Insurers argue HHS must clamp down on dialysis patient steering
Payers and a major union group said CMS should reissue its rule on steering in the individual market to prohibit financially interested third parties from making insurance payments.
By David Lim • April 18, 2018
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New APM seeks to improve opioid disorder treatment
The AMA and the American Society of Addiction Medicine have unveiled the Patient-Centered Opioid Addiction Treatment advanced payment model, which looks to improve care coordination.
By Les Masterson • April 17, 2018
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Amazon reportedly drops plan to distribute pharmaceuticals to hospitals
The report is not entirely unexpected. Amazon in December canceled its pharmaceutical wholesaler application in Maine and told state regulators it did not intend to sell drugs.
By David Lim • April 17, 2018
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CVS hires Iora Health's CMO to run MinuteClinic
The CVS-brand clinics will likely play a key role if the company's proposed $69 billion merger with Aetna gets regulatory approval.
By Les Masterson • April 16, 2018
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eConsult bolsters specialist access, but barriers remain, JAMA study says
A review of web-based consultations between primary care doctors and specialists found they can result in better care coordination, but some PCPs complained about added responsibilities and administrative burden.
By Les Masterson • April 16, 2018
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New Jersey moves closer to its own individual mandate
The state legislature also approved a reinsurance program to help payers cover the sickest members. Both moves look to stabilize the individual market and ACA exchange.
By Les Masterson • April 16, 2018
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Short-term plan expansion will hike individual market premiums, lower enrollment
The Trump administration wants to expand short-term plans, also known as catastrophic plans, to anyone and increase their duration from three months to one year.
By Les Masterson • April 13, 2018
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Hospitals must improve medication adherence system use to protect patients, report says
Many hospitals are struggling to properly use technology designed to prevent bedside medication errors.
By David Lim • April 13, 2018
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JAMA report finds wide health variations by state
Hawaii had the highest life expectancy at birth in 2016 (81.3 years) while Mississippi had the lowest (74.7 years).
By Les Masterson • April 12, 2018
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Deep DiveThe VA privatization debate: 5 things to know
As the nominee for VA secretary awaits his confirmation hearing, debate is heating up over how involved healthcare's private sector should be in the second-largest federal agency.
By Tony Abraham • April 11, 2018
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Deep DiveIs the doctor shortage problem overblown?
While supply is not keeping up with population growth, technology and use of non-physicians may ease any shortfall.
By Meg Bryant • April 11, 2018
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Medicaid improves access, preventive services, AHIP report says
The study comes as Virginia considers becoming the 34th state to expand Medicaid under the ACA.
By Les Masterson • April 11, 2018
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Medicare Advantage gets supplemental benefits flexibility, including for transport
The change opens the door to benefits not directly related to healthcare, such as meal delivery and ride-hailing services like Lyft.
By Meg Bryant • April 10, 2018
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California bill would create healthcare price controls
The proposal would authorize an independent commission to set private health plan prices based on what Medicare pays for those services.
By Meg Bryant • April 10, 2018
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States get more power over ACA essential health benefits with final rule
The sweeping rule is the latest in the Trump administration’s steady chipping away at the landmark health law, which has been coupled with a move to give states more control over their healthcare regulations.
By Jeff Byers • April 09, 2018
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M&A risks patient safety, JAMA report warns
Mergers, acquisitions and affiliations are led by financial experts who may not prepare organizations for changes in patient population and practice settings.
By Les Masterson • April 09, 2018
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CVS points finger back at pharma for drug prices
The retail giant says it managed to keep drug costs flat despite 8.3% specialty drug pricing growth.
By Suzanne Elvidge • April 09, 2018
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Medicare to pay hundreds of thousands for CAR-T therapies
CMS will give hospitals outpatient reimbursements of about $400,000 for Gilead's Yescarta and $500,000 for Novartis' Kymriah.
By Jacob Bell • April 06, 2018