Government: Page 122
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ACOs using medical home physicians save money, yield higher quality, report finds
"ACOs and patient-centered medical homes are cut out of the same cloth," Robert Mechanic, executive director of the Institute for Accountable Care, said about the research.
By Rebecca Pifer Parduhn • Aug. 8, 2018 -
Small, medium payers show growing interest in provider-sponsored plans
A new white paper looked at that payer marketplace niche, which has seen significant turnover in the past five years.
By Les Masterson • Aug. 8, 2018 -
CMS to allow step therapy in MA plans in bid to boost price competition
Dan Best, CMS senior advisor for drug pricing reform, told reporters the policy could save 15-20% of the $12 billion annual spend by MA plans on oft-pricey Part B drugs. Not all analysts buy that estimate.
By David Lim • Aug. 8, 2018 -
Market concentration tied to higher premiums in ACA markets, study finds
Premiums in marketplaces with monopolist insurers were 50% higher than in markets with more than two insurers, according to a Health Affairs report.
By Meg Bryant • Aug. 7, 2018 -
CMS' Verma stands firm on 2015 EHR deadline, move to open APIs
Meanwhile, the coalition Health IT Now sent a letter to ONC chiding the government for failing to implement information blocking provisions of the 21st Century Cures Act.
By Meg Bryant • Aug. 7, 2018 -
Drugs make up more US health spending than thought, report suggests
Research published in Health Affairs found that drugs accounted for 15% of the country's total healthcare spending in 2016, higher than the oft-cited 10% figure.
By Ned Pagliarulo • Aug. 6, 2018 -
More employers look toward value-based insurance plans
After years of implementing cost-sharing policies like the use of high-deductible plans, businesses are looking for new avenues to reduce costs and improve health.
By Les Masterson • Aug. 6, 2018 -
CMS finalizes rule requiring hospitals to post prices online
The inpatient rule also cuts reporting periods down to 90 consecutive days, nixes the 25% threshold policy for long-term care hospitals and cuts a number of reporting measures.
By Tony Abraham • Aug. 3, 2018 -
Healthcare M&A remains hot, but value fell in Q2
Despite the activity, there was only one industry megadeal in the quarter — KKR's $10 billion buy of Envision.
By Les Masterson • Aug. 3, 2018 -
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 -
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 Parduhn • 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 Parduhn • 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 Parduhn • 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 Parduhn • 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
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