Drug costs pushed one-third of Americans to skip a prescription in the past year: GoodRx

Nearly all respondents to a recent survey said they had health insurance, yet 42% noted they were still having difficulty paying for medications.

By Jacob Bell • Nov. 26, 2018

California imposes conditions on CHI-Dignity Health merger

The state approved the deal so long as the two health systems agree to certain measures meant to preserve access to care and financial aid. The two will operate 30 hospitals in California.

By Samantha Liss • Nov. 26, 2018

More than half of health data breaches triggered internally, study finds

Still, more than a third of the incidents are caused by theft from outsiders or unknown parties, according to an analysis of HHS data.

By Meg Bryant • Nov. 21, 2018

People with limited health insurance literacy more likely to avoid care

Plain-language communication from trusted healthcare professionals could help improve health literacy and lead to more use of preventive services, according to a new study in JAMA.

By Les Masterson • Nov. 21, 2018

CMS should give states more info to improve Medicaid MCO data reliability, GAO says

Of the eight states studied, three use an additional oversight practice to compare encounter data with an external data source and five use other mechanisms to enforce reporting requirements, including penalties, according to the watchdog.

By Les Masterson • Nov. 21, 2018

Consumerism (and Amazon) loom over #USNHoT

Disruption doesn't have to come from the tech sector, said healthcare execs at the U.S. News & World Report Healthcare of Tomorrow conference. Businesses must prioritize customer relationships, data and convenience to stay ahead.

By Rebecca Pifer Parduhn • Nov. 20, 2018

FDA plan would ease regulations for prescription drug apps

The agency is seeking public comment on a proposed regulatory framework that would treat most prescription drug apps, including dose calculators, symptom trackers and medication reminders, as promotional labeling.

By Susan Kelly • Nov. 20, 2018

Telehealth laws inhibit widespread use in Medicare population, CMS says

The agency is opening up virtual care in some alternative payment models, but use among fee-for-service beneficiaries is just 0.25%, according to a new report. The states with the highest use are Texas, Iowa and California.

By Meg Bryant • Nov. 19, 2018

Primary care physician visits drop among patients with employer plans

Office visits for all providers went up between 2012 and 2016 despite the drop for primary care physicians, pointing to a bigger role for nurse practitioners and physician assistants, according to the Health Care Cost Institute.

By Les Masterson • Nov. 19, 2018

Pfizer tests Trump with plans to hike prices on 41 drugs

Last month, Pfizer CEO Ian Read indicated the pharma would soon return to "business as normal" after a rare reversal on price hikes made in July. 

By Ned Pagliarulo • Nov. 19, 2018

Lack of competition leads to higher ACA plan premiums in rural areas

Lower premiums in urban areas are partially related to more competition among plans and providers, according to a new report from the Urban Institute.

By Les Masterson • Nov. 19, 2018

House chairman sees 'every indication' that VA's EHR difficulties will continue

"Frankly," Indiana Rep. Jim Banks said, "the more I learn about the EHR program, the more daunting it has become." 

By Tony Abraham • Nov. 15, 2018

CVS-Aetna merger cleared by California's insurance regulator

The state's reluctant nod came after the entity promised not to increase premiums as a result of acquisition costs. The deal now awaits regulatory approval from four more states and is expected to close by Thanksgiving.

By Rebecca Pifer Parduhn • Nov. 15, 2018

In rebound, ACA marketplace to offer more payer options in 2019

Despite concerns of more problems in 2018, ACA payers have actually found their footing — and are even enjoying profits now. Centene, Cigna, Oscar Health, Anthem and Wellmark are moving back into the market or expanding to more counties in 2019.

By Les Masterson • Nov. 15, 2018

CMS approves Michigan Medicaid drug value-based payment plan

Administrator Seema Verma also previewed forthcoming agency action on protected classes of drugs in Medicare Part D, hinting that CMS plans to further open the space to private negotiation.

By David Lim • Nov. 14, 2018

Managed Medicaid plans treat chronic conditions on par with other commercial coverage, AHIP report finds

The payer group looked at data involving patients with asthma, diabetes and mood disorders to see how clinical care compared between Medicaid, commercial insurance and those who are uninsured.

By Les Masterson • Nov. 14, 2018

'Stay tuned,' says Azar: CMMI to take a closer look at social determinants of health

It's unclear how the administration will balance tackling social determinants of health and keeping regulatory burden low.

By Rebecca Pifer Parduhn • Nov. 14, 2018

Nearly 50K would lose Medicaid under Arkansas work rules: study

Gresham v. Azar seeks to halt the work requirement experiment on grounds it runs counter to Medicaid law and risks the health of Arkansas' most vulnerable citizens.

By Meg Bryant • Nov. 14, 2018

It's final: Amazon pegs NYC, Virginia for HQ2 (with nod to Nashville)

The Tennessee capital was a surprise winner, landing 5,000 jobs as part of an "operations center of excellence." 

By Samantha Liss • Nov. 13, 2018

CMS finds Strong Start birth centers save money, improve outcomes

Rates of preteen birth, unhealthy birthweight and cesarean section were all lower among birth center participants — as were costs.

By Les Masterson • Nov. 12, 2018

Post midterm win, Medicaid backers eye expansion in more red states

Victories in three states are inspiring backers in Missouri, Mississippi and Oklahoma who found themselves boxed out by Republican lawmakers unwilling to extend health coverage to more low-socioeconomic status residents. 

By Samantha Liss • Nov. 12, 2018

HHS teases mandatory bundled models in about-face

If such methods are needed to deliver change, HHS Secretary Alex Azar said Thursday, "mandatory models are going to see a comeback."

By Rebecca Pifer Parduhn • Nov. 9, 2018

Without more stewardship, superbugs could kill thousands more Americans annually by 2050

But spending just $2 per person a year on measures like handwashing and more sensible prescribing could prevent three out of four of those deaths, according to the Organisation for Economic Co-operation and Development.

By Meg Bryant • Nov. 9, 2018

Medicaid managed care proposal would tweak network adequacy standards

The proposed rule from CMS aims to create flexibility by removing "outdated" requirements that govern how plans communicate with beneficiaries and barriers to transitioning new services and populations into managed care.

By Tony Abraham • Nov. 9, 2018

Price, usage drive variations between regions' healthcare costs, report finds

Of six regions studied, Maryland had the lowest costs at 20% below the benchmark. On the other end, Colorado was 19% above the standard and Minnesota was 11% higher.

By Les Masterson • Nov. 9, 2018