Government: Page 127
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Deep Dive
GE, Medtronic among those linking with hospitals for value-based care
Manufacturers are putting their money where their mouth is — tying payment to real outcomes.
By Meg Bryant • March 29, 2018 -
Healthcare M&A leading to higher prices in California
A University of California, Berkeley study said northern California pays much higher healthcare prices than the southern part of the state.
By Les Masterson • March 28, 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 -
PhRMA goes after drug 'middlemen' in new ad attack
The trade group accused insurers and PBMs of preventing patients from reaching their deductibles by changing how copay coupons are processed.
By Ned Pagliarulo • March 28, 2018 -
Alex Wong via Getty Images
AHA argues HHS religious freedom rule unnecessary
The hospital group is also concerned that the proposed rule may endanger federal reimbursement if OCR takes action against a provider.
By David Lim • March 28, 2018 -
HHS panel recommends testing 2 alternative palliative care payment models
Also, a new Health Affairs article explored the complexity of including hospice care in Medicare Advantage.
By Les Masterson • March 28, 2018 -
Legislation looks to limit length of opioid prescriptions
The American Medical Association has called for more research on the topic and said prescription length depends on situation and type of care.
By Les Masterson • March 27, 2018 -
Plans shirking ACA rules could spur more out-of-network care
Allowing health coverage to be sold across state lines could also limit oversight, a report by state regulators said.
By Les Masterson • March 27, 2018 -
Montgomery County Planning Commission
Aetna to offer point of sale pharmacy rebates to 3M customers
The insurer has opposed the CMS idea to mandate that Part D sponsors pass on a percentage of rebates to customers at the point of sale.
By David Lim • March 27, 2018 -
CMS mum on restricting how payers use subsidies
Insurers that offer ACA plans often use the practice of "silver loading," which involves putting all the losses associated with the end of CSR payments on only silver plans.
By Les Masterson • March 26, 2018 -
Most employers short of tipping point for health coverage
The American Health Policy Institute predicted employers won't be rushing to drop health insurance as a benefit, but some will go that route in the face of unmanageable healthcare costs.
By Les Masterson • March 26, 2018 -
CMS proposes to reduce state Medicaid requirements for monitoring access
The proposed rule is part of the Trump administration's drive to cut administrative red tape.
By Meg Bryant • March 23, 2018 -
Centene fined $100K for not fixing provider network inadequacies
The Washington state insurance commissioner says the payer has not adhered to its compliance plan following a $1.5 million fine last December.
By David Lim • March 23, 2018 -
ACA plan premium changes varied widely
Large premium hikes were connected to marketplace uncertainty, policy changes and payers dropping out of the exchanges, according to the Urban Institute.
By Les Masterson • March 22, 2018 -
Geisinger plans pilot to help patients get to appointments
Geisinger’s program will also provide transportation for non-clinical, but health-related reasons, such as going to counseling, a pharmacy, a grocery store or to a job interview.
By Les Masterson • March 22, 2018 -
White House report targets health insurer profitability
The Council of Economic Advisers report argues many insurance companies' net profit margins have returned to pre-ACA levels on the backs of taxpayers.
By David Lim • March 21, 2018 -
HHS makes case against hospitals' 340B suit in new filing
"Setting aside the final rule for 2018 would direct payments away from these other services while creating administrative havoc in the OPPS system," HHS argued in a court filing this week.
By David Lim • March 21, 2018 -
Blues plans made money in individual market last year
Payers still face an uncertain 2018 and 2019 in the ACA exchanges.
By Les Masterson • March 20, 2018 -
Elizabeth Regan/Healthcare Dive
Big Data is the 'new gold rush,' report predicts
Among companies making a play in data analytics is Alphabet's life sciences arm Verily.
By Meg Bryant • March 20, 2018 -
Maryland's all-payer model saved Medicare millions in first 3 years
A review of the state program found that it's on track to meet CMS-imposed targets for savings and patient safety.
By Les Masterson • March 19, 2018 -
Hospital prices see biggest gain in years, hiring on upswing
Hospital prices grew at their highest rate since 2009. Overall healthcare costs saw the highest increase since 2012.
By Les Masterson • March 19, 2018 -
CMS finalizes coverage of DNA sequencing for cancer patients
The agency will cover similar tests approved by the FDA.
By Jeff Byers • March 19, 2018 -
Trump to pitch national PDMP to fight opioid crisis
The president will visit New Hampshire to announce a slate of proposals, including calling for legislation to allow Medicaid to reimburse residential treatment at facilities with more than 16 beds.
By David Lim • March 19, 2018 -
Alex Wong via Getty Images
CMS plans MACRA changes to ease burden
CMS is expected to add more alternative payment models and is hoping to automatically receive quality data from EHRs rather than physicians reporting the data.
By Les Masterson • March 19, 2018 -
AMA survey says prior authorizations hurting clinical outcomes
Nearly one-third of physicians said they needed to wait at least three business days for a prior authorization decision, and doctors say the payer requests are rising.
By Les Masterson • March 19, 2018 -
ACA stabilization bills may become part of spending package
The Congressional Budget Office said resurrecting CSR payments could reduce premiums and increase the number of insured Americans.
By Les Masterson • March 16, 2018
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