Government: Page 125
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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 -
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 Parduhn • 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 -
Drug lobby ramps up jabs at PBMs with pitch to curb rebates
PhRMA wants PBMs to be compensated on a fee-for-service basis, rather than from a percentage cut of a drug's list price.
By Ned Pagliarulo • July 19, 2018 -
GAO finds most 340B hospitals are rural, critical access
While the amount of charity and uncompensated care was higher among general acute care hospitals, the report found critical access hospitals provided less uncompensated care than those not in the program.
By Tony Abraham • July 19, 2018 -
Hikma ramping up injectable opioid output for US hospitals
The American Medical Association declared drug shortages to be a national public health emergency last month, and the stream of opioids available to providers has continued to dry up.
By Rebecca Pifer Parduhn • July 19, 2018 -
Jacob Bell/Healthcare Dive
FDA seeks to make more drugs available over the counter
Drugs that could change to over-the-counter products — with additional labeling and education of consumers — include cholesterol-lowering meds and the opioid-overdose reversal drug naloxone.
By Barbara Boughton • July 19, 2018 -
ACA Medicaid pay boost didn't lure docs, JAMA study says
Possible reasons for this lack of interest were delayed payments, a finite timeframe and documentation requirements to qualify.
By Les Masterson • July 18, 2018 -
Nearly half of antibiotics inappropriate in urgent care, CDC study says
Incorrect prescribing was prevalent in other outpatient settings as well, including emergency departments, medical offices and retail clinics.
By Rebecca Pifer Parduhn • July 18, 2018
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