Hospital execs admit lack of readiness for Ebola in 2014, but defenses improving

Most said they could adequately respond to such an emergency now, but acknowledge they were not ready to handle Ebola cases during the outbreak, according to a report from the HHS Office of Inspector General.

By Les Masterson • Oct. 22, 2018

CVS-Aetna merger hits snag in New York, clears Connecticut

New York financial regulators want assurances the companies won't raise premiums in the state.

By Meg Bryant • Oct. 22, 2018

At least 40% of Medicare Advantage plans to offer pop health benefits

Avalere analyzed CMS data on MA coverage for newly allowed benefits including bathroom safety devices, over-the-counter meds and transportation assistance.  

By Les Masterson • Oct. 22, 2018

Doubt cast on value of hospital accreditation in Harvard study

"Given the minimal benefit seen with accreditation in this study, it raises the question of whether our national efforts need to emphasize accreditation as much as they do," researchers said.

By Meg Bryant • Oct. 19, 2018

Study finds 40% of doctors pessimistic about practice of medicine

This unease includes concern about their practice's financial stability and administrative management, as well as use of EHRs, according to a new Leavitt Partners white paper.

By Les Masterson • Oct. 19, 2018

Stakeholders call for transparency, ease of use in EHR Reporting Program

In comments, several healthcare organizations requested a centralized clearinghouse of existing health IT comparison resources.

By Meg Bryant • Oct. 18, 2018

Industry on Medicare ACO plan: too much risk too fast

Some providers warn they'll drop out if CMS finalizes its proposal as is. Others contend the agency is cracking down on the program in an attempt to kill it.

By Tony Abraham • Oct. 18, 2018

Medicaid expansion doesn't impede care access or cause longer wait times, study finds

A new National Bureau of Economic Research working paper found no change in office visits, number of days between visits, expenditures and wait times after Medicaid expansion.

By Les Masterson • Oct. 18, 2018

Insurers see broad market opportunities with end-of-life care

"The reimbursement rates are strong and it's a profitable service to be delivering," said Avalere's Dan Mendelson. "Whenever you have that kind of situation you're going to also have speculative buying and desire to grow these markets."

By Rebecca Pifer Parduhn • Oct. 17, 2018

#AHIPMMD speakers mull role of government regulation in healthcare

As payers gathered at AHIP's annual conference on Medicare, Medicaid and dual eligibles, hot topics included the promises of Medicare Advantage, the role of the federal government and drug prices.

By Samantha Liss • Oct. 17, 2018

5 questions on the Trump admin's bid to mandate prices in drug ads

The proposal is expected to face fierce opposition from industry and raises a wide range of legal, political and economic questions.

By Ned Pagliarulo , Andrew Dunn • Oct. 17, 2018

#AHIPMMD: Verma touts MA growth, blasts Medicare for all

So far, 270 Medicare Advantage plans will offer new benefits allowed for 2019 that include adult day care and meals, the CMS administrator said at the annual payer conference.

By Samantha Liss • Oct. 17, 2018

GAO study underscores health benefits of Medicaid expansion

Voters in four states will decide on expansion initiatives in the midterm elections next month.

By Meg Bryant • Oct. 16, 2018

CVS CEO unfazed by Amazon, focused on closing merger, growth

In a speech to the Economic Club of Washington, Larry Merlo said his goal is to not "leave any white space for Amazon to disrupt."

By Rebecca Pifer Parduhn • Oct. 16, 2018

Anthem shells out $16M in largest ever HIPAA fine

The settlement will pay for four years of credit monitoring and all other claims, costs and fees for affected members.

By Rebecca Pifer Parduhn • Oct. 16, 2018

Aetna settles HIV disclosure investigation for close to $650K

The multistate settlement stems from 2017 mailings that revealed some policyholders' HIV/AIDS or A-fib status.

By Meg Bryant • Oct. 15, 2018

Confronting pharma, Trump admin seeks price disclosure in drug ads

HHS chief Alex Azar announced the much-anticipated proposal Monday, dismissing a new pledge from trade lobby PhRMA as insufficient.

By Andrew Dunn • Oct. 15, 2018

Immigration rule change could force millions off Medicaid, report warns

The Trump administration is proposing a change to "public charge" policies that could also lead to higher costs for providers via uncompensated care and more ER visits, according to the Kaiser Family Foundation.

By Les Masterson • Oct. 15, 2018

States requiring hospitals provide more info on 340B drugs

Most states don't track 340B drug payments after rebates, but gaining that information could ultimately result in a change to reimbursement amounts.

By Les Masterson • Oct. 15, 2018

Grassley urges FTC to investigate hospital-payer contracts

The Senate Judiciary chairman is concerned that anticompetitive contracts could limit access to affordable care.

By Meg Bryant • Oct. 12, 2018

Massachusetts officials attach stiff conditions to Beth Israel-Lahey merger

The requirements follow a report warning the merger could result in a $128.4 million to $170.8 million spending increase for inpatient, outpatient and adult primary care services.

By Meg Bryant • Oct. 12, 2018

Average ACA premiums will drop for first time in 2019

Payers put through huge premium increases over the past two years, meaning next year's rates are likely a market correction.

By Les Masterson • Oct. 12, 2018

'Nowhere to hide' for rivals after blockbuster CVS-Aetna deal

The nearly $70 billion merger poses threats to providers as its scale and access to care aims to shift the healthcare dynamic in favor of consumers, BDO's David Friend told Healthcare Dive.

By Samantha Liss • Oct. 11, 2018

CMS touts more highly-ranked MA prescription plans next year

More than 36% of Medicare beneficiaries are expected to have Medicare Advantage plans in 2019.

By Les Masterson • Oct. 11, 2018

CMS bid to overhaul E/M codes leaves few happy

With its proposed changes to payments and documentation for office visits, the agency is effectively forcing providers to reckon with a longstanding, oft-disputed problem. 

By Tony Abraham • Oct. 10, 2018