Government: Page 125
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CMS mulling direct provider contracting models
The concept grew out of an earlier request seeking guidance on a "new direction" for the Center for Medicare and Medicaid Innovation to promote patient-centered care and test market-driven reforms.
By Meg Bryant • April 24, 2018 -
Report finds most short-term plans don't cover maternity, substance misuse care
The expansion of short-term plans could have an adverse affect on the ACA-compliant individual market, according to the Kaiser Family Foundation.
By Tony Abraham • April 24, 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 -
CMS pushes hospitals to post prices online
A sweeping 1,800-page proposed rule also would eliminate 25 quality measures across five programs with an aim to ease administrative burden and improve EHR interoperability.
By Jeff Byers , David Lim , Tony Abraham • Updated April 25, 2018 -
Centene ACA exchange membership spiked 35% in past year
The insurer posted better-than-expected earnings off of increased membership and lower Medicaid medical costs despite an intense flu season.
By David Lim • April 24, 2018 -
Court allows class-action CSR payment lawsuit
The Department of Justice may appeal the ruling, which could ultimately result in billions of dollars in subsidies to payers offering plans in the ACA marketplace.
By Les Masterson • April 23, 2018 -
Managed care group looking at new MA plan benefits
A new CMS rule paves the way for plans to offer benefits not directly labeled as healthcare, such as ride-hailing services like Uber and Lyft that can help patients get to appointments.
By Meg Bryant • April 23, 2018 -
Walmart, Emory Healthcare working together on new ACO
Walmart has been at the forefront of a trend that sees employers contracting directly with providers in hopes of improving care while also reducing costs.
By Les Masterson • April 23, 2018 -
Payer trade groups slam short-term health plan proposal
The insurance lobbies argued that other policy mechanisms would be more effective at improving the individual health insurance market.
By David Lim • Updated April 24, 2018 -
AMA calls for greatly reduced MIPS reporting period
Physicians were not informed of their MIPS eligibility until early April despite being responsible for tracking and collecting data as of Jan. 1.
By Tony Abraham • April 23, 2018 -
Potential Medicare APM overlap an increasing concern
Competing payment models in the same area "may have far-reaching impact on provider incentives and behavior," the authors of a recent Health Affairs blog post said.
By Les Masterson • April 19, 2018 -
Illinois stops Medicaid enrollment to state's BCBS
The state sanctioned the payer’s Medicaid managed care plan after it reportedly didn't meet patient access guidelines.
By Les Masterson • April 19, 2018 -
Healthcare megadeals may have major long-term impact, Moody's says
Payer vertical integration could put more pressure on hospital volumes and margins, according to a new report.
By Les Masterson • April 18, 2018 -
FDA targets medical device safety in new plan
The plan includes integrating the device center's premarket and postmarket offices.
By Meg Bryant • April 18, 2018 -
ACP says dozens of MIPS quality measures are not valid
The American College of Physicians has joined other prominent groups in questioning the positive impact of the Merit-based Incentive Payment System track under MACRA.
By Tony Abraham • April 18, 2018 -
3 states could have Medicaid expansion on the ballot
Meanwhile, Arizona is requesting a waiver to stop Medicaid recipients from getting retroactive coverage up to three months before a person applies for coverage.
By Les Masterson • April 18, 2018 -
Healthcare sharing ministries: 5 things to know
These alternatives to regular health insurance have grown to nearly 1 million people this decade.
By Les Masterson • April 18, 2018 -
Alex Wong via Getty Images
Insurers argue HHS must clamp down on dialysis patient steering
Payers and a major union group said CMS should reissue its rule on steering in the individual market to prohibit financially interested third parties from making insurance payments.
By David Lim • April 18, 2018 -
New APM seeks to improve opioid disorder treatment
The AMA and the American Society of Addiction Medicine have unveiled the Patient-Centered Opioid Addiction Treatment advanced payment model, which looks to improve care coordination.
By Les Masterson • April 17, 2018 -
Amazon reportedly drops plan to distribute pharmaceuticals to hospitals
The report is not entirely unexpected. Amazon in December canceled its pharmaceutical wholesaler application in Maine and told state regulators it did not intend to sell drugs.
By David Lim • April 17, 2018 -
Bruce Bennett via Getty Images
CVS hires Iora Health's CMO to run MinuteClinic
The CVS-brand clinics will likely play a key role if the company's proposed $69 billion merger with Aetna gets regulatory approval.
By Les Masterson • April 16, 2018 -
eConsult bolsters specialist access, but barriers remain, JAMA study says
A review of web-based consultations between primary care doctors and specialists found they can result in better care coordination, but some PCPs complained about added responsibilities and administrative burden.
By Les Masterson • April 16, 2018 -
New Jersey moves closer to its own individual mandate
The state legislature also approved a reinsurance program to help payers cover the sickest members. Both moves look to stabilize the individual market and ACA exchange.
By Les Masterson • April 16, 2018 -
Short-term plan expansion will hike individual market premiums, lower enrollment
The Trump administration wants to expand short-term plans, also known as catastrophic plans, to anyone and increase their duration from three months to one year.
By Les Masterson • April 13, 2018 -
Hospitals must improve medication adherence system use to protect patients, report says
Many hospitals are struggling to properly use technology designed to prevent bedside medication errors.
By David Lim • April 13, 2018 -
JAMA report finds wide health variations by state
Hawaii had the highest life expectancy at birth in 2016 (81.3 years) while Mississippi had the lowest (74.7 years).
By Les Masterson • April 12, 2018
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