Government: Page 118
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Opioid prescriptions aren't decreasing, study finds
The results come despite myriad attempts from lawmakers, providers and payers to curb opioid use, including prescribing and dosage restrictions.
By Les Masterson • Aug. 2, 2018 -
Final rule expands short-term health plans to 12 months
The plans can now have a maximum duration of a year, but can be renewed for a total of three years. HHS expects 600,000 people to enroll next year with as many as 6 million by 2022.
By Tony Abraham • Aug. 1, 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 -
Unsubsidized coverage drops but individual market still stable
A Kaiser Family Foundation report found that about 2 million people dumped individual coverage over the past year, mostly middle-class Americans without subsidies to help control premiums.
By Les Masterson • Aug. 1, 2018 -
OIG fines eClinicalWorks for failing to report patient safety issues
The reporting requirement was part of a corporate integrity agreement originating from a $155 million settlement over falsification of EHR certification standards.
By Rebecca Pifer • July 31, 2018 -
Patients often choose higher-cost locations for MRIs, study finds
Referring physicians have more influence over a patient's decision than out-of-pocket costs, according to the National Bureau of Economic Research report.
By Les Masterson • July 31, 2018 -
Industry split on CMS site neutrality proposal
Hospitals and health systems say site-neutral payments would hinder access for patients. Doctors and some policy experts argue that access shouldn't hinge on payment disparity.
By Tony Abraham • July 31, 2018 -
Centene, Ascension joining forces for Medicare Advantage plan
Though there are few specifics about the plan, the companies said it would be a preferred model for the systems and affiliates in multiple markets.
By Les Masterson • July 31, 2018 -
ACOs may affect physician employment patterns, JAMA study finds
The report showed an increase in ACO enrollment was connected with fewer physician work hours per week and fewer doctors choosing self-employment.
By Les Masterson • July 30, 2018 -
CMS advisers split on procedure volume rules for TAVR
Edwards LifeSciences and Medtronic offered different takes on the current coverage policy.
By Susan Kelly • July 30, 2018 -
States sue Trump administration over AHP expansion
Critics fear that by tempting people with lower-cost offerings, AHPs and catastrophic plans could cause millions to flee the ACA exchanges.
By Les Masterson • July 30, 2018 -
Higher Medicaid rates improved behavioral health, study finds
The National Bureau of Economic Research analyzed spillover from the largest federally-mandated increase in Medicaid reimbursement rates, stemming from the Affordable Care Act.
By Rebecca Pifer • July 26, 2018 -
Pharma, medtech spending accounted for 28% of CME funds in 2017
This was the fourth consecutive yearly increase in medical education spending from companies in those sectors.
By Rebecca Pifer • July 26, 2018 -
CMS rule proposes site neutral payments, extends 340B cuts
The American Hospital Association accused the agency of showing "a lack of understanding about the reality in which hospitals and health systems operate daily to serve the needs of their communities."
By Tony Abraham • July 25, 2018 -
Anthem sees 23% net growth, eyes Medicare, Medicaid options
The payer's revenue was hurt by its pull-back from the ACA exchanges.
By Les Masterson • July 25, 2018 -
CMS reinstates ACA risk-adjustment payments
The agency said a final rule reviving the program will go into effect immediately because it "is imperative to maintain stability and predictability in the individual and small group health insurance markets."
By Rebecca Pifer • July 25, 2018 -
Centene revenue up on ACA plan growth
The payer reported a 19% increase in year-over-year Q2 revenues to $14.2 billion.
By Les Masterson • July 24, 2018 -
UnitedHealth sees growing interest in ACOs
The nation's largest private payer expects ACOs will continue to grow over the next year as employers look for ways to cut costs and improve quality.
By Les Masterson • July 23, 2018 -
Non-physician providers improve practice bottom lines, MGMA says
The survey also found that operating costs for primary care practices rose 13% over the past five years.
By Les Masterson • July 23, 2018 -
State individual mandates would boost coverage, curb premiums
The Commonwealth Fund reported there would be more than 7 million fewer uninsured people in 2022 if all states implemented individual mandates.
By Les Masterson • July 23, 2018 -
Deep Dive
Health systems increasingly think small. At the micro level.
"It's intended to be the 'Honey, I Shrunk the Kids' version," one hospital executive quipped about the micro-campus goal.
By Les Masterson • July 23, 2018 -
Halting safe harbor rebates will hike premiums, Wall Street analysts say
PBMs wouldn't suffer much from the proposal, but would instead pass costs onto the government and beneficiaries.
By Les Masterson • July 23, 2018 -
Beth Israel-Lahey Health merger would sharply hike health costs, Mass. panel finds
The attorney general has also raised concerns about the proposed deal, which would result in one of the largest mergers in the state’s history.
By Meg Bryant • July 20, 2018 -
CMS re-opens Kentucky Medicaid work mandate comment period
The move comes after a federal judge rejected the agency's approval of a waiver for the state.
By Tony Abraham • July 20, 2018 -
Controversial Anthem ER policy under fire in lawmaker's report
Under its policy of denying payment for ER visits later determined not to be emergencies, the insurer denied 5.8% of claims in three states across a six-month stretch in 2017. On appeal, a majority of those were later overturned.
By Rebecca Pifer • July 20, 2018 -
ACA risk adjustment fix reportedly in the works
An interim final rule that could reinstate the $10.4 billion in risk adjustment payments to insurers CMS suspended earlier this month is being considered by the Office of Management and Budget.
By Tony Abraham • July 20, 2018
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