Fixing provider directories a low-risk way to test blockchain, report suggests

UnitedHealth, Humana and Quest Diagnostics are among those working on a pilot blockchain project to update provider directories.

By Les Masterson • June 11, 2018

ED visits increased nearly 10% in California after ACA

A Health Affairs study also found the chance of a Medicaid enrollee being a frequent ED user was "significantly lower" after the Affordable Care Act was signed into law.

By Les Masterson • June 8, 2018

DOJ argues ACA pre-existing condition, individual mandates unconstitutional

The Trump administration said that with Congress zeroing out the penalty starting in 2019, the health law's individual mandate, community rating and guaranteed issue provisions cannot stand.

By David Lim • Updated June 8, 2018

Reduction in hospital-acquired conditions saved $2.9B over 2 years

An Agency for Healthcare Research and Quality report found improved patient safety in 2015 and 2016 prevented about 8,000 deaths.

By Les Masterson • June 7, 2018

Study raises concerns about Medicaid managed care's narrow networks

A Health Affairs report said states need to make sure that physician turnover in narrow network plans doesn't create issues with doctor continuity for vulnerable populations.

By Les Masterson • June 7, 2018

BIO18: FDA to issue guidance on cell and gene therapy in July

Commissioner Scott Gottlieb also said the industry needs to move toward continuous manufacturing of these treatments.

By Lisa LaMotta • June 7, 2018

NIH lays out strategic plan for evolving field of data science

In particular, it points to the rapid growth of EHR and genomic data.

By Meg Bryant • June 6, 2018

Bucking national trend, Pennsylvania payers seek modest exchange premium hikes

While many states worry there will be less competition in the individual market next year, Pennsylvania is seeing an uptick of participation in the exchange.

By Les Masterson • June 6, 2018

Medicaid expansion improved care access and coverage, analysis finds

More than 30 states have expanded Medicaid under the ACA, and a few more will have the issue up for a vote this fall.

By Les Masterson • June 6, 2018

Mandatory CMS bundles showed advantages over voluntary initiatives, report finds

A Health Affairs report found mandatory and voluntary bundled payment models "engaged different types of hospitals."

By Les Masterson • June 6, 2018

CMS announces new Medicaid transparency tool

State Medicaid directors said they are concerned about the "comparability, accuracy and timeliness of the data" and said differences in care delivery approaches from state to state might be lost in translation.

By Tony Abraham • June 5, 2018

Losing ACA mandate penalty will reverse coverage gains, report finds

A Brookings analysis that focused on those not eligible for ACA subsidies found the individual mandate was the major reason the group got insured.

By Les Masterson • June 4, 2018

AMA trumpets physician efforts in opioid epidemic fight

The doctors' group said opioid prescriptions are down while prescription drug monitoring program queries are up.

By Les Masterson • June 1, 2018

Trump administration pushes 340B ceiling price rule to 2019

It is the fifth delay for the rule, which would also set a penalty for drugmakers that overcharge participating hospitals.

By Tony Abraham • June 1, 2018

Healthcare pricing transparency remains elusive, study finds

A JAMA Network survey found that even fewer hospitals provided pricing information in 2016 than did for a similar study four years earlier.

By Les Masterson • May 31, 2018

Days of information blocking look numbered

Government pressure and emerging business incentives are encouraging companies to share data.

By Meg Bryant • May 31, 2018

Healthcare groups mixed on proposed direct provider contracting model

Some groups support DPC as a way to increase access to alternative payment models, but others fear it is too redundant and encouraged CMS to fix other programs instead.

By Les Masterson • May 30, 2018

Virginia on cusp of expanding Medicaid

The state Senate on Wednesday moved past the most significant hurdle to expand Medicaid to an additional 400,000 residents, a long-sought goal of Democrats using the powers under the Affordable Care Act.

By David Lim • Updated May 31, 2018

Readmission rates among BPCI episodes show room for improvement

Groups mulling participation in the Bundled Payment for Care Improvement Advanced model may find success in targeting certain high readmission rates, according to a new report from Avalere.

By Shannon Muchmore • May 30, 2018

ACA health insurance tax would be delayed 2 years under bipartisan bill

Insurance companies say ending the tax would let them reduce premiums by 3%.

By Les Masterson • May 29, 2018

Medicaid expansion sees movement in Virginia, may get vote in Idaho

Virginia could become the next state to expand Medicaid, with the state legislature expected to vote in the coming days on a plan that would tax hospitals to fund the added coverage. 

By Les Masterson • May 29, 2018

California to hospitals: 'Time's up' on unnecessary procedures

Covered California is threatening to oust hospitals with high C-section rates from participating health plans' provider networks.

By Meg Bryant • May 25, 2018

Comments criticize CMS plan to cut Medicaid care access monitoring

Healthcare officials said the change could especially hurt rural hospitals and force facilities to take lower rates without any recourse.

By Les Masterson • May 24, 2018

$5.2B bill extending VA private sector options passes Congress

President Donald Trump is expected to sign the compromise measure, which is backed by most major veterans groups and stops short of full privatization.

By Tony Abraham • May 24, 2018

CMS primary care model slowed ED visits, but did not cover costs

A new study found no significant differences between participants in the Comprehensive Primary Care Initiative and comparison practices when examining spending growth.

By David Lim • May 24, 2018