Government: Page 107
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Better quality, lower costs when providers and payers share risk
Integrated Healthcare Association's review of California care found that capitation is connected with better healthcare quality.
By Les Masterson • April 15, 2019 -
Safety net hospitals near 'breaking point,' advocacy group says
America's Essential Hospitals said safety net facilities saw their average margin cut in half in 2017.
By Les Masterson • April 12, 2019 -
Medicaid reimbursement, not expansion status, affects doctors' acceptance of new patients
The percentage of providers willing to take on new Medicaid patients also did not change based on a state's Medicaid managed care offerings, according to an analysis of MACPAC data.
By Les Masterson • April 11, 2019 -
Pharmacy's 'middlemen' counter pharma's campaign to shift the price blame
Banning rebates will not be a silver bullet leading to cost control, PBM executives argued in front of the Senate Finance Committee.
By Jonathan Gardner • April 9, 2019 -
Hospital execs argue disruptors will 'skim the cream,' ignore community health
CEOs of Henry Ford Health System and Yale New Haven Health worry new entrants in healthcare could divert revenue from hospitals, leaving them with unnegotiable Medicare and Medicaid payments.
By Tony Abraham • April 9, 2019 -
Hospitals, payers decry HHS proposal to change safe harbor for drug rebates
The comments come as chiefs at the big pharmacy benefit managers — UnitedHealthcare's Optum, Cigna's Express Scripts and CVS Caremark — take the hot seat before the Senate Finance Committee on Tuesday.
By Les Masterson • April 9, 2019 -
Emergency department visits rose, but misuse fell in 2016
Wait times improved, according to the CDC data. Nearly 40% of patients had wait times of less than 15 minutes and 72% waited less than an hour.
By Les Masterson • April 8, 2019 -
CMS gives MA plans telehealth boost with expanded benefits
Building on recently finalized policies to expand supplemental benefits, the rule also seeks to update star ratings methodology and improve the appeals process for dual eligible beneficiaries.
By Tony Abraham • April 8, 2019 -
340B program leads to higher costs, PhRMA-commissioned report finds
The research conducted by Berkeley Research Group is the latest skirmish in a battle over the program, which health systems argue helps safety net hospitals access affordable prescription drugs.
By Les Masterson • April 8, 2019 -
MedPAC wants to redesign MA quality bonus program
The advisory commission also voted Thursday to recommend Congress pass legislation to withhold some Medicare Advantage plan payments if an insurer's encounter data is wrong or incomplete.
By Rebecca Pifer Parduhn • April 5, 2019 -
3 issues that put VA officials on defense in front of Congress this week
VA Secretary Robert Wilkie and others argued in a series of hearings that the agency is prepared to roll out its community care program by the deadline two months from now and that its EHR implementation woes are improving.
By Tony Abraham • April 5, 2019 -
Bruce Bennett via Getty Images
CVS expands same-day Rx delivery to 6K stores
Increasing home delivery options could be a huge advantage for the drugstore retailer against rivals like Walgreens and even Amazon.
By Daphne Howland • April 5, 2019 -
PBM group says HHS drug rebate proposal would increase costs more than predicted
However, Fitch Ratings said in a new forecast it doesn't expect the change will have a long-term impact on margins or profits for payers, drug companies or distributors.
By Les Masterson • April 5, 2019 -
Imprivata, Verato leverage biometrics in effort to improve patient matching
The companies say linking Imprivata's patient identification tool with Verato's cloud-based master patient index will ensure patients are matched with the correct medical records.
By Meg Bryant • April 4, 2019 -
Amazon's Alexa now has HIPAA-compliant features
Six companies taking part in the online giant's invitation-only developer program launched their features Thursday, including Atrium Health, Cigna, Express Scripts and Livongo.
By Shannon Muchmore • April 4, 2019 -
Alex Wong via Getty Images
CMS approves Maine's long-awaited Medicaid expansion
The state's voters approved expansion in November 2017 for implementation no later than July 2018. However, then-governor Paul LePage, a Republican, refused to carry out the measure last year.
By Rebecca Pifer Parduhn • April 4, 2019 -
Medicaid expansion improves community health center finances, access to care
Centers in the three dozen expansion states are more likely to offer behavioral health counseling and coordinated care than non-expansion states, according to The Commonwealth Fund.
By Les Masterson • April 4, 2019 -
Industry groups seek cybersecurity safe harbor
In response to a senator's request, several organizations highlighted the need for a national strategy and greater collaboration among various stakeholders, according to a think tank that read the responses.
By Meg Bryant • April 3, 2019 -
UnitedHealthcare, AMA team up on billing codes for social determinants
The two entities are developing 23 ICD-10 codes that could help address patients' socioeconomic needs by connecting them to relevant resources and social services.
By Tony Abraham • April 3, 2019 -
Hospital, doctor lobbies support surprise billing protections — but not bundled payments
The American Hospital Association and other industry groups railed against the concept in a letter Tuesday following a congressional hearing on the topic of surprise billing.
By Samantha Liss • April 3, 2019 -
Uninsured, Medicaid patients more likely to be transferred, JAMA study shows
The study also examined whether hospital ownership plays a role in patient care and found that for-profit hospitals were more likely to transfer uninsured patients.
By Samantha Liss • April 2, 2019 -
Brian Tucker/Healthcare Dive
HHS publishes 340B drug ceiling prices in concession to hospital lobby
The publication follows roughly eight years of delay and legal action from the American Hospital Association.
By Rebecca Pifer Parduhn • April 2, 2019 -
CMS finalizes nontraditional MA benefits, use of encounter data
The agency is allowing MA plans to cover expenditures associated with social determinants of health, such as covering the cost of fresh produce for beneficiaries with heart disease or carpet cleaning for people with asthma.
By Tony Abraham • Updated April 3, 2019 -
Utah's partial Medicaid expansion cleared by CMS, sidestepping voters
The partial plan also includes work requirements, coming days after a federal judge knocked down similar mandates in Kentucky and Arkansas.
By Les Masterson • April 1, 2019 -
Employers overwhelmingly support ACA's pre-existing condition protections
The results come as the Trump administration's Department of Justice wants the courts to kill the landmark health law and its popular protections and essential benefits.
By Les Masterson • April 1, 2019
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