Express Scripts joins Walgreens Boots to cut biosimilar costs

The pharmacy benefit manager is expanding its agreement with the drug store giant to simplify the supply chain for specialty pharmaceuticals. 

By Lisa LaMotta • Feb. 21, 2018

Anthem's cost-cutting drive riles providers

The payer said the E/M payment cut is one way to reduce costs for its members and employer clients, but critics say the change may require patients to return for another doctor visit. 

By Les Masterson • Feb. 21, 2018

Explore the 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

JAMA: Admin costs vary by type of visit

The researchers said their findings could be used to inform policies that reduce administrative costs.

By Les Masterson • Feb. 20, 2018

UPDATE: CMS seeks expansion of short-term plans to sidestep ACA

HHS acknowledges that the exodus of young and healthy exchange members could contribute to rising premiums within the ACA exchange markets.

By Jeff Byers , David Lim • Feb. 20, 2018

Tax cuts a win for most for-profit hospitals, Moody's says

HCA and Universal Health Services will get the most out of the change, while others won’t benefit as much due to interest deductibility limits.

By Les Masterson • Feb. 20, 2018

Anthem makes exceptions to controversial ER policy

In the six states where Anthem denies ER claims it later deems unnecessary, patients who receive treatment on a weekend or receive certain services, for example, are now exempt. 

By Shannon Muchmore • Feb. 16, 2018

CMS to watch and wait on Idaho Blue Cross's ACA-skirting plans

HHS Secretary Alex Azar told lawmakers the department would look at the health plans and measure them against ACA requirements once it receives a waiver request from the insurer.

By David Lim • Feb. 16, 2018

FDA OKs marketing of AI-enabled stroke alert for providers

The Viz.AI app was cleared via the de novo premarket review process.

By Meg Bryant • Feb. 15, 2018

Georgia hospitals sue Anthem over ER, imaging policies

Anthem will shortly stop paying for imaging in hospitals and for emergency department care that it later deems not an emergency.  

By Les Masterson • Feb. 15, 2018

Healthcare spending to reach 19.7% of GDP within a decade

Hospital care spending growth is expected to increase 5.5% on average between 2017 and 2026, the report finds.

By Jeff Byers • Feb. 14, 2018

Reducing healthcare costs not one-size-fits-all, report finds

The Network for Regional Healthcare Improvement analyzed healthcare costs for five states and found huge differences in terms of costs and drivers.

By Les Masterson • Feb. 14, 2018

Most healthcare execs say value-based programs led to positive financial results

A Healthcare Financial Management Association survey also said commercial payers haven’t rolled out value-based programs as quickly as expected.  

By Les Masterson • Feb. 14, 2018

DOJ to no longer use guidance docs as binding rules for enforcement

The revised policy could have major ramifications for False Claims Act lawsuits and other federal litigation.

By Meg Bryant • Feb. 13, 2018

Hospitals performed small amount of cost-shifting, study finds

Recent research found that hospitals negotiated 1.5% higher average private payer reimbursements to offset cuts from public payers.

By Les Masterson • Feb. 13, 2018

CMS ends Obama policy requiring docs to rewrite students' medical notes

Starting March 5, physicians will only need to verify the information.  

By Les Masterson • Feb. 12, 2018

Trump budget slashes Medicaid, targets 340B

The proposal is more a political document than anything else, but HHS Secretary Alex Azar said it addresses priorities including a push toward paying for value.

By Shannon Muchmore , David Lim • Feb. 12, 2018

More oversight for 340B needed, White House council says

The Council of Economic Advisers suggested creating an independent agency to oversee the prescription payment program.  

By Les Masterson • Feb. 12, 2018

GAO: Medicare cost-sharing update would involve trade-offs

Capping beneficiary out-of-pocket costs could reduce demand for supplemental insurance, the agency said.

By Meg Bryant • Feb. 9, 2018

ACA enrollment fell overall, but ticked up in state-run exchanges

The figures don't tell the whole story, however. The 2018 numbers were expected to fall well below previous signups after the Trump administration spent the past year trying to dismantle the ACA.

By Les Masterson • Feb. 9, 2018

3 reasons evidence-based policy is hard

Academics and policymakers gave advice on the challenges to making evidence-based policy at a recent healthcare conference.

By Shannon Muchmore • Feb. 9, 2018

Hospital consolidation has spotty track record, experts say

Even blocking a "very vanilla merger" is a costly endeavor, Nathan Wilson, an economist at the Federal Trade Commission, said.

By Jeff Byers • Feb. 9, 2018

Smorgasbord of health items in massive 2-year budget deal

The agreement staving off an extended government shutdown includes a delay to Disproportionate Share Hospital payment cuts, a repeal of the ACA's Independent Payment Advisory Board and more funding to fight the opioid crisis.

By David Lim • Feb. 9, 2018

Management organizations can play key role in ACOs

A Health Affairs report found partnerships helped providers in ACOs with data, administrative, educational and care coordination services.

By Les Masterson • Feb. 7, 2018

Express Scripts: Plan drug spending rose at slowest rate in 24 years

The PBM says its efforts to rein in rising drug costs have helped the plans it administers secure hundreds of millions in savings last year.

By Ned Pagliarulo • Feb. 7, 2018

Industry blasts FDA Clinical Decision Software draft

A group that includes software providers, medical device makers and drugmakers says that if implemented, the draft guide would "force many sellers of existing CDS software to remove their products from the market."

By David Lim • Feb. 7, 2018