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

GAO says assisted living facilities need better oversight by state Medicaid

The agency found 26 state Medicaid agencies could not report the number of critical incidents that occurred in assisted living facilities.

By Les Masterson • Feb. 6, 2018

Expanding ACA plans drove Centene to 8% revenue growth

In announcing its Q4 earnings, the payer raised its guidance for 2018 after a successful open enrollment period in the ACA exchanges. 

By Les Masterson • Feb. 6, 2018

How to make population health pop: What experts say

Barriers to successful pop health initiatives include quantifying and monetizing health information that may not lend itself to such analysis and getting organizations with different priorities to work together.

By Shannon Muchmore • Feb. 6, 2018

Highest healthcare spenders vary each year

The top 5% of healthcare spenders in 2015 accounted for 53% of spending, a new Health Care Cost Institute analysis found.

By Les Masterson • Feb. 5, 2018

Community health centers face funding deadline, layoffs and closure

Congress may include a two-year extension of funding for the centers as part of the continuing resolution to keep the government open. 

By Les Masterson • Feb. 5, 2018

Glenview strains relations with Tenet over 'underperformance'

Some believe Glenview Capital Management, Tenet's largest shareholder, is preparing to launch a boardroom battle with the hospital company.  

By Les Masterson • Feb. 5, 2018

Medicaid work requirements bring uncertainty to hospital bottom lines, Fitch warns

Kentucky has already received a Medicaid waiver that allows it to implement work requirements, and seven more states could follow shortly.

By Meg Bryant • Feb. 2, 2018

UPDATE: Indiana Medicaid work waiver approved

The Trump administration is giving states more flexibility in running Medicaid, but critics say some changes restrict access to care for the most needy.

By Les Masterson • Feb. 2, 2018

DOJ seeks more info on proposed CVS, Aetna merger

CVS did not say what information DOJ is seeking, but the request is not unexpected.

By Shannon Muchmore • Feb. 2, 2018

Medicare Advantage plans to see 1.84% rate bump

CMS is also proposing opioid prescribing limits starting in 2019 for Part D plans to help stem the opioid crisis.

By David Lim • Feb. 2, 2018

Changes from DC could mean a difficult year ahead for hospitals

​Issues facing hospitals this year include Medicaid DSH cuts, a possible return of mandatory bundling initiatives and CMS potentially moving hip replacement procedures to outpatient.  

By Les Masterson • Feb. 1, 2018

Physician practices not flocking to CPC+

Just 165 practices have signed up to participate in round two of the CMS public-private partnership.

By Meg Bryant • Jan. 31, 2018

A proposal to bolster ACA exchanges: Look to Medicare Advantage

The Urban Institute suggests five Medicare Advantage-inspired policies to stabilize the ACA market.

By Les Masterson • Jan. 31, 2018

Payers wade into real-world evidence, but tread lightly

Insurers and pharmacy benefit managers are wary about the quality of data underlying real-world evidence.

By David Lim • Jan. 31, 2018

How Amazon, JPM, Berkshire could disrupt healthcare (or not)

News of three corporate giants forming an independent healthcare company "proves every business is a healthcare business," said David Vivero, CEO of the digital health startup Amino.

By Shannon Muchmore, Daphne Howland & Jeff Byers • Jan. 31, 2018

State of the Union: 4 things Trump said on healthcare

Most of the healthcare ideas the president put forward have little chance of being enacted this year or lack funding to be effective.

By David Lim • Jan. 31, 2018

Court sets speedy 340B lawsuit schedule, siding with AHA

"We will continue to pursue our legislative and legal strategies to reverse these cuts, and expect to prevail in holding the agency accountable for overstepping its authority," Melinda Hatton, general counsel for the American Hospital Association, told Healthcare Dive.

By David Lim • Jan. 31, 2018