Patient attribution crucial part of value-based contracting, actuaries say

There are trade-offs between attribution methods that rely on retrospective reviews of fee-for-service claims and those that attribute patients in advance of performance periods, according to a Society of Actuaries report.

By Les Masterson • Sept. 17, 2018

Hospitals, telehealth providers prepare for Hurricane Florence

As with last year's Hurricanes Harvey and Irma, hospital operators in Florence's path could take a financial hit. HCA, Tenet, Community Health Systems and LifePoint Health could all see volumes dip.

By Meg Bryant • Sept. 14, 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

Payer trade group highlights need for housing programs

Housing is one of the most complex social determinants of health, and insurers have partnered with other health organizations to invest in affordable real estate and expand case management services, according to AHIP.

By Les Masterson • Sept. 14, 2018

When ICE comes knocking, healthcare workers want to be prepared

Hospital staff are on the front lines in the fight against a growing threat to their patients' health: fear.

By Tony Abraham • Sept. 14, 2018

Managed care companies, providers would benefit from Medicaid expansion

Four states with ballot initiatives this fall to expand Medicaid could boost bottom lines of big-name payers and health systems, according to a new report.

By Les Masterson • Sept. 12, 2018

California law brings more scrutiny of payer mergers

Payers must get approval from the state for any transaction that affects a "significant number of enrollees," "involves a material amount of assets" or adversely affects "the stability of the health care delivery system."

By Les Masterson • Sept. 12, 2018

Michigan threatens to repeal Medicaid expansion if work requirements not approved

Two JAMA studies bolster critics of work requirements who say most Medicaid recipients who are able to work are already doing so, and tracking compliance will heap more administrative burden onto an already-taxed system.

By Rebecca Pifer • Sept. 12, 2018

Hospitals sue to require drug pricing transparency in 340B

HHS delayed implementing the regulations for the fifth time in June and has signaled they will be rolled into the administration's larger plan to cut drug costs.

By Tony Abraham • Sept. 12, 2018

Walgreens to take over 185 Fred's pharmacies

The dissolution of Fred's pharmacy operations is quite a departure from the drugstore's ambitions a year ago.

By Daphne Howland • Sept. 11, 2018

Kaiser Permanente commits to being carbon neutral by 2020

The Oakland-based integrated system said its purchase of 180 megawatts of clean energy will make the company the largest purchaser of renewable energy in the U.S. healthcare sector.

By Les Masterson • Sept. 11, 2018

Calls for more transparency after Memorial Sloan controversy

Renowned breast cancer researcher José Baselga, also CMO at Memorial Sloan Kettering, accepted millions of dollars from companies but failed to reveal those payments in published research.

By Meg Bryant • Sept. 11, 2018

Physician wellness, quality of care go hand-in-hand, analysis finds

Health systems should factor in how burnout affects performance, care quality and safety outcomes as they conduct business and treat patients, the authors of the JAMA report said.

By Les Masterson • Sept. 10, 2018

Modest ACA plan premium changes expected for 2019

Following a year of concern about hefty rate increases and the possibility of some counties not having any ACA plan options, 2019 is shaping up to be a stable year for the exchanges.

By Les Masterson • Sept. 10, 2018

Montana co-op wins $5.3M CSR lawsuit

The judge ruled that the federal government didn't fulfill its obligation under the ACA when it stopped the cost-sharing reduction payments last year.

By Les Masterson • Sept. 7, 2018

Medicaid waivers put transport benefits on chopping block

A new study shows non-emergency medical transportation saves Medicaid more than $40 million per month for every 30,000 beneficiaries. But some states have the longstanding benefit in their sights.

By Tony Abraham • Sept. 7, 2018

Physician-led ACOs saw savings in Medicare program

Hospital-integrated ACOs, however, didn't have the same success, according to a study published in the New England Journal of Medicine.

By Les Masterson • Sept. 6, 2018

JAMA studies show upsides of CMS bundled payment models

The reports found reduced institutional post-acute discharges with the CJR program and no increase in patient volume for the BPCI model.

By Les Masterson • Sept. 6, 2018

PhRMA, hospital war over drug prices heats up

The drugmaker lobby issued a report contending hospitals upcharge meds by 500% as a hospital-led effort to develop cheaper generics took a step forward.

By Rebecca Pifer • Sept. 6, 2018

Federal judge mulls ACA's constitutional standing

The Texas judge is reportedly "strongly considering" that the ACA is unconstitutional without its individual mandate penalty. A decision on the lawsuit could arrive any time before the end of the year.

By Tony Abraham • Sept. 5, 2018

Gottlieb: UnitedHealth, CareFirst sign onto FDA pilot aiming to speed device coverage

The FDA chief also outlined new programs including "QUiK Review" aimed at cutting review times for well-understood, low-risk 510(k) submissions "by as much as 30%."

By David Lim • Sept. 5, 2018

Medicare ACOs saved $1.1B in 2017, CMS data show

It comes after CMS officials predicted an overhaul of the Medicare Shared Savings Program would push ACOs to take on more financial risk in their first years of participation.

By Les Masterson • Sept. 4, 2018

CMMI director says agency won't force all providers to assume risk

Adam Boehler said, however, that CMS wants to "create that avenue" for any practices interested in taking on more risk.

By Rebecca Pifer • Aug. 31, 2018

Uninsured rate stays stable in 2018

Use of high-deductible health plans continued an upward trend, with nearly half of people with private insurance saying they have such coverage, new federal statistics show.

By Les Masterson • Aug. 30, 2018

Report offers framework for assessing EHR usability, safety

The voluntary roadmap includes criteria examples for developers and providers to use in testing EHR products at each lifecycle stage.

By Meg Bryant • Aug. 29, 2018

Hundreds of groups raise concerns about E/M payment proposal

They support efforts to cut provider administrative burden in the 2019 Physician Payment Rule but question its consolidation of office billing codes.

By Les Masterson • Aug. 29, 2018