Government: Page 114
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Maryland reinsurance program credited for premium decreases
Before CMS approved the program, the state's four individual health plans requested an average increase of 30.2%, but they have now put forward rates with an average decrease of 13.2%.
By Les Masterson • Sept. 26, 2018 -
Medicaid expansion particularly helped rural areas, small towns, report finds
"Overall, the experience of Medicaid expansion states demonstrates the great opportunity for states that have not yet expanded Medicaid," Jack Hoadley, lead author of the report, said in a statement.
By Les Masterson • Sept. 26, 2018 -
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 -
Montgomery County Planning Commission
New York regulator warns CVS-Aetna merger could raise prices, reduce consumer choice
The state's top financial watchdog said the pharmacy chain's PBM would have an incentive to give the largest drug discounts to Aetna members, causing "anti-competitive effects" in the rest of the market.
By Samantha Liss • Sept. 26, 2018 -
Gilead creates subsidiary to sell generic versions of hep C blockbusters
Asegua Therapeutics will sell authorized generics of Harvoni and Epclusa at an annual list price of $24,000 for the most common course of therapy.
By Jacob Bell • Sept. 25, 2018 -
Reports explore connection between race, ethnicity, socioeconomics, health
The study by U.S. News and the Aetna Foundation found that the strongest predictors of community health performance were factors like high homicide rates, low birth weight and access to healthy, affordable food.
By Les Masterson • Sept. 25, 2018 -
Major healthcare groups question Medicare ACO proposal
CMS would like more providers to take on risk, but practices have been slow to transition.
By Les Masterson • Sept. 24, 2018 -
Medicaid spending increase expected to exceed GDP growth over next decade
A new HHS Office of the Actuary report projected an average annual rate increase of 5.7% until 2026.
By Les Masterson • Sept. 24, 2018 -
CMS chooses organizations to help develop QPP quality measures
The seven participants include a hospital, specialty groups, colleges and an employer coalition. Their focus areas will include mental health, orthopedic surgery, pathology, radiology and palliative care.
By Les Masterson • Sept. 24, 2018 -
TV filming at Massachusetts hospitals leads to $1M in HIPAA fines
Boston Medical, Brigham and Women's and Massachusetts General were hit with the fines for allowing ABC documentary crews for "Save My Life: Boston Trauma" to tape patients on premises without obtaining prior authorization.
By Tony Abraham • Sept. 21, 2018 -
Iowa's Medicaid managed care costs rise faster than before
Medicaid per-member costs increased an average of 4.4% in the first full year of privatization. That's nearly triple the 1.5% average the previous six years.
By Les Masterson • Sept. 21, 2018 -
Lack of consistent process hinders data sharing among HHS agencies, report finds
Issues include lack of processes and accountability for data sharing, as well as resource constraints.
By Meg Bryant • Sept. 20, 2018 -
Prescriptions, ED visits, outpatient services drive healthcare spending growth
The Health Care Cost Institute found that employer-sponsored insurance spending increased by 44% between 2007 and 2016.
By Les Masterson • Sept. 20, 2018 -
For-profit hospitals show higher rates of readmission
In light of their findings, study authors urged policymakers to "mitigate any potential risks in the quality of patient care arising from unintended revenue pressure in healthcare institutions."
By Rebecca Pifer • Sept. 20, 2018 -
Puerto Rico health system struggling to recover from Hurricane Maria, report finds
Mental health and chronic disease care are particular problems in the area, according to the Kaiser Family Foundation.
By Les Masterson • Sept. 20, 2018 -
Nearly half of resident physicians experience burnout, JAMA study finds
Researchers also found substantial differences in physician burnout estimates and how they were measured, which complicates finding consistency among studies.
By Les Masterson • Sept. 19, 2018 -
AbbVie accused of 'far-reaching' kickback scheme for Humira
A lawsuit filed by the California Department of Insurance puts AbbVie on the defensive over support programs for its top-selling biologic drug.
By Ned Pagliarulo • Sept. 19, 2018 -
Senators take aim at surprise billing
A draft bill from a bipartisan group would ban balance billing and require that insurers, rather than patients, pay out-of-network providers at 125% of the average in-network rate.
By Tony Abraham • Sept. 19, 2018 -
AHA, on defense, pitches 340B 'stewardship'
The principles amount to the industry's riposte to calls for increased oversight and transparency by watchdogs and lawmakers in both parties.
By Rebecca Pifer • Sept. 19, 2018 -
Medicare ACOs save more money with more time, Avalere says
The Medicare Shared Savings Program has been scrutinized recently as more performance data surface. After the initiative missed federal cost savings projections from 2013 to 2016, recent results have been more promising.
By Les Masterson • Sept. 19, 2018 -
HHS launching database of patient safety culture at ambulatory surgical centers
The decision comes as the centers are treating more patients — a trend being pushed by payers, including Medicare, that want to move care away from more expensive inpatient settings.
By Les Masterson • Sept. 18, 2018 -
CMS proposes streamlining some Medicare compliance rules
If finalized, the rule would remove the requirement that ambulatory surgical centers have a written transfer agreement with a hospital or that the center's physicians have admitting privileges at a nearby hospital.
By Tony Abraham • Sept. 18, 2018 -
NQF report focuses on rural-relevant quality measures
The National Quality Forum's Measure Applications Partnership workgroup looked for measures that are cross-cutting, resistant to low case volume and drive access to care.
By Meg Bryant • Sept. 18, 2018 -
Challenge to short-term plans joins chorus of ACA lawsuits
While the outcome of a lawsuit threatening the landmark law is pending in Texas, patient advocates in Washington, D.C., and the Maryland attorney general are suing to protect the act.
By Les Masterson • Sept. 17, 2018 -
Cigna-Express Scripts merger cleared by DOJ
Federal regulators said the deal "is unlikely to result in harm to competition or consumers." Eyes now turn to the proposed Aetna-CVS union.
By Samantha Liss • Sept. 17, 2018 -
Patient groups attack CVS use of ICER metrics, urge rethink
In an open letter, more than 90 organizations called on CVS to reconsider its decision to use ICER's drug value assessments for determining coverage.
By Andrew Dunn • Sept. 17, 2018
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