JAMA findings suggest 'unintended harm' from Hospital Readmissions Reduction Program

The study shows an association between the program and 30-day post-discharge mortality in heart failure patients.

By Meg Bryant • Dec. 21, 2018

Policy upheaval, tech giant disruption and megamergers: Healthcare Dive's 10 best stories of 2018

This year in healthcare was marked by sweeping changes.

By Rebecca Pifer • Dec. 21, 2018

Explore the Trendline➔

Labor

Hospitals are navigating persistent labor shortages with the need to cut costs — a source of contention that could leave patients caught in the middle.

By Healthcare Dive staff

340B hospital drug spending higher than at non-340B facilities, report says

The analysis funded by the pharmaceutical industry is the latest in a heated battle between 340B hospitals and drugmakers over the benefits to the program and the impact on drug spending.  

By Les Masterson • Dec. 21, 2018

Most hospitals sharing data, but challenges remain, ONC says

A majority of hospitals use a mix of electronic and nonelectronic methods to send and receive patient care summaries, the new analysis shows.

By Meg Bryant • Dec. 20, 2018

ACA federal exchange enrollment drops about 4%

The slump is not as significant as many had feared, and shows the law is "far from dead," said Kaiser Family Foundation's Larry Levitt.

By Les Masterson • Dec. 20, 2018

Study finds 'mixed messages' in Medicare hospital ratings, penalty programs

The report echoes other findings that question the usefulness of hospital rankings.

By Meg Bryant • Dec. 19, 2018

ACA ruling could upend Medicaid expansion

Policy experts say it's hard to overstate the chaos the ruling would create if it stands, although many legal scholars doubt it will be upheld. Still, some managed care companies have contingency plans.

By Samantha Liss • Dec. 19, 2018

Reinsurance program, higher subsidies would further ACA coverage gains

In a new report, the Urban Institute suggested a variety of policy changes that it said would insure more than 12 million additional people.

By Les Masterson • Dec. 19, 2018

Judge calls for expedited briefings in ACA case

The parties have until Friday to file their responses on whether a stay is warranted, whether the court should enter partial final judgment on the order and whether the court should certify the order for immediate repeal.

By Shannon Muchmore , Tony Abraham • Dec. 19, 2018

Federal judge suggests CVS-Aetna be monitored by outside appointee

Judge Richard Leon of the D.C. District Court also rebuked the DOJ for its "tone deaf" brief questioning Leon's right to review the merger under 2004's Tunney Act.

By Rebecca Pifer • Dec. 18, 2018

Labor board will charge Kaiser for refusing to bargain, union says

NLRB will prosecute Kaiser before the end of the year if it does not settle with union workers, according to an email obtained by Healthcare Dive. The health system said the decision is not a verdict, but the start of a hearing process.

By Tony Abraham • Dec. 18, 2018

Most Medicaid managed care programs consider social determinants of health

Still, few payment incentives involve those factors, according to a new report by the Association for Community Affiliated Plans and the Center for Health Care Strategies.

By Les Masterson • Dec. 17, 2018

What to expect after whirlwind ACA ruling

The decision, now being challenged by a coalition of Democratic attorneys general, would effectively wipe out Medicaid expansion and pre-existing condition protections and could affect a number of hospital payment reforms.

By Rebecca Pifer • Updated Dec. 18, 2018

A case of the Blues: BCBS plans' appeal rejected, must face antitrust allegations

The 11th U.S. Circuit Court of Appeals upheld a ruling that 36 Blue Cross Blue Shield plans' agreement to limit competition while staking claim in exclusive markets is a per se violation of the Sherman Antitrust Act.

By Tony Abraham • Dec. 14, 2018

Texas judge rules ACA unconstitutional

Providers blasted the ruling, which will appealed to a higher court.

By Tony Abraham • Updated Dec. 18, 2018

HHS seeks ideas on HIPAA tweaks to boost care coordination

The aim is to reduce regulatory burden and facilitate care, with a focus on the opioid crisis.

By Meg Bryant • Dec. 13, 2018

DOJ takes up lawsuit accusing Sutter Health of cheating Medicare

The whistleblower lawsuit alleges the California health system and an affiliate manipulated diagnosis codes to inflate payments.

By Meg Bryant • Dec. 13, 2018

ACO trade group says Medicare program saved $859M in 2016

The program, which includes 561 accountable care organizations and 10.5 million patients, saved more than $660 million between 2013 and 2016 after bonuses paid to providers for meeting spending and quality targets.

By Les Masterson • Dec. 13, 2018

PwC: 'New Health Economy' finding its feet, but challenges remain

Providers are embracing digital treatments, with 77% saying they have suggested an app or digital program to a patient, according to the industry trends report.

By Meg Bryant • Dec. 12, 2018

1 in 5 patients at high risk of socioeconomic health problem, survey finds

Patients who discuss their social determinant of health challenges with a clinician are more likely to accept help, according to the study. Younger patients, while twice as likely to discuss, are less receptive to assistance.

By Tony Abraham • Dec. 12, 2018

4.2M Americans eligible for free ACA coverage, KFF says

In Iowa, Nebraska, Delaware and Utah alone, roughly half of potential marketplace shoppers could get a 2019 bronze plan with a $0 premium, according to the analysis.

By Rebecca Pifer • Dec. 12, 2018

Lawmakers impatient for ONC interoperability rule

"It is hard to explain to people that Congress provided the tools necessary for doctors and patients to better coordinate their care through the sharing of patient data, but nothing has changed," Rep. Michael Burgess, R-Texas, said at a House health subcommittee hearing.

By Rebecca Pifer • Dec. 11, 2018

Payer, hospital groups trade blame on surprise billing

The problem of patients unexpectedly getting a bill for out-of-network services is common and growing, especially for people getting emergency room care.

By Les Masterson • Dec. 11, 2018

Middle-income Americans paying more for health insurance

Americans in the South are hardest hit — spending a bigger share of their income on healthcare than other parts of the country.

By Les Masterson • Dec. 10, 2018

CMS reinstates risk adjustment program for ACA exchanges

In February, a federal judge in New Mexico vacated the risk adjustment program, namely the statewide average premium in the HHS methodology.

By Les Masterson • Dec. 10, 2018