Pharma breathes easy as Trump's drug pricing plan fizzles

While Trump vowed to bring drug prices down, pharma and biotech stocks jumped higher after his speech delivered few immediate actions. 

By David Lim • May 11, 2018

Report suggests standardizing Medicare Advantage bidding process

The authors estimated the changes would save the federal government $10 billion annually and reduce Part B premiums for both traditional and MA beneficiaries by about 2% per year.

By Les Masterson • May 11, 2018

What to expect from Trump's drug pricing speech Friday

The president is expected to lay out his administration's latest slate of proposals aimed at lowering the cost of drugs.

By David Lim • May 10, 2018

Trump wants to cut billions from CHIP

Congress reauthorized the Children’s Health Insurance Program for 10 years as part of a large spending package in February.

By Les Masterson • May 9, 2018

Azar urges acceleration of care to non-hospital settings in AHA speech

The HHS secretary also said a recent proposed mandate for hospitals to post standard charges online is only a first step to combating practices such as surprise billing.

By David Lim • May 9, 2018

CMS unveils strategy to improve rural healthcare

Objectives for the plan include advancing telehealth, empowering patients in rural communities and leveraging partnerships to achieve rural health goals.

By Les Masterson • May 9, 2018

Payers propose hefty ACA exchange premium hikes

The higher rates insurers in Virginia and Maryland proposed were expected after the Trump administration zeroed out the individual mandate penalty.

By Les Masterson • May 8, 2018

CMS rejects Kansas plan to create lifetime Medicaid limits

Meanwhile, New Hampshire became the fourth state to get approved for work requirements and Utah moved a step closer to getting an expansion of the program on the ballot this fall.

By Les Masterson • May 8, 2018

Veterans Choice program could get a makeover

The program for veterans who live far from a VA clinic will run out of funding next month. Legislation introduced in the House would revamp the program to lean more heavily on private sector providers.

By Tony Abraham • May 7, 2018

Most ACOs would leave MSSP if forced into risk, survey finds

Accountable care organizations are leery of the amount of risk they could face in the program next year such as unpredictable changes by CMS.

By Meg Bryant • May 4, 2018

NIH precision medicine project seeks insights on 1M Americans

The aim is to lessen the need for costly and lengthy clinical trials by amassing a database of health and lifestyle information researchers can probe to understand how people may respond to different treatments.

By Meg Bryant • May 3, 2018

Virtual care moves toward the frontline of provider-patient relationships

Kaiser Permanente and UnitedHealthcare are among those using telehealth programs in place of primary care visits and quick patient consultations.

By Les Masterson • May 3, 2018

Humana credits TRICARE contract in 18.7% Q1 membership growth

The payer also raised its guidance, citing strong Medicare Advantage numbers.

By David Lim • May 2, 2018

Survey shows reversal in ACA coverage gains

A report from the Commonwealth Fund found the rate of uninsured people between ages 19 and 64 has increased to 15.5% from 12.7% in 2016.

By Tony Abraham • May 2, 2018

SEIU health workers set to protest potential Kaiser layoffs

Kaiser Permanente said the decision to outsource the pharmacy storage and distribution network came after extensive discussions with SEIU-UHW and other unions.

By David Lim • April 30, 2018

Bipartisan group pushes opioid action plan

The bill would direct HHS Secretary Alex Azar and a pain management task force to recommend changes to Medicare and Medicaid to increase access to medication-assisted treatment and reduce opioid addiction.

By Suzanne Elvidge • April 30, 2018

FDA lays out next steps for Pre Cert pilot

Nine companies are taking part, including Apple, Fitbit and Johnson & Johnson. The program aims to reduce certification checkpoints for software companies for low-risk software-based medical devices.

By David Lim • April 27, 2018

CMS releases new Medicare Advantage data resource

Administrator Seema Verma announced a new data strategy and said Medicare Advantage encounter data are now available, with annual updates planned.

By Tony Abraham • April 26, 2018

Value-based pay a factor pushing docs to hospital work

The trend may raise costs, though, and there are signs it may be slowing.

By Les Masterson • April 25, 2018

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

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