Right to Try fails amid warning from regulators, patient groups

Backers of the bill, like President Trump and the Koch brothers, faced off against major patient groups and some regulators.

By David Lim • March 14, 2018

HDHPs can be more cost-effective for consumers, report says

A new National Bureau of Economic Research working paper looked at how much people could save over a year by going with high-deductible health plans.  

By Les Masterson • March 14, 2018

Labor, administrative costs drive US healthcare spending far beyond other nations

The report found the U.S. pays more for healthcare than other high-income countries, but has the lowest percentage of insured people, the lowest life expectancy and the highest infant mortality rate.

By Les Masterson • March 13, 2018

Drug spending growth to come solely from specialty meds, report says

Developed markets will shell out more than $300 billion for the often complex, expensive treatments this year, according to new estimates from IQVIA.

By Jacob Bell • March 13, 2018

Restoring CSR funds with no reforms may do more harm

The individual market endured an end to cost-sharing reduction payments, but reviving them without more changes could threaten stability, a new report said.  

By Les Masterson • March 12, 2018

GOP actions may spur huge ACA premium hikes

Premiums could skyrocket by more than 90% in some states over the next three years, according to a report by Covered California.

By Les Masterson • March 12, 2018

Medicare Advantage risk-adjustment proposal causes alarm

The American Hospital Association and other groups are concerned about the plan to use more patient encounter data when calculating risk scores.

By Les Masterson • March 9, 2018

CMS denies Idaho bid to sell plans not compliant with ACA

Agency head Seema Verma said that despite the denial, the state could meaningfully implement many of the same goals legally through short-term, limited-duration plans. 

By David Lim • March 9, 2018

UnitedHealth Group plans more scrutiny of ED claims

The payer will review emergency claims with the most serious conditions and reduce or deny any incorrect claims it finds.

By Les Masterson • March 8, 2018

Gottlieb takes aim at payers, pharmas for blocking biosimilars

The FDA chief lambasted PBMs, insurers and branded drugmakers for allegedly blocking market entry of the copycat biologics.

By Lisa LaMotta , David Lim • March 8, 2018

Out-of-pocket healthcare costs up 11% in 2017

Highest out-of-pocket cost estimates were for orthopedics, plastic surgery, urology and neurology.  

By Les Masterson • March 7, 2018

Insurers, hospitals slam Trump admin's association health plan proposal

America’s Health Insurance Plans argued the proposal could increase the risk of fraud and insolvency for consumers.

By David Lim • March 7, 2018

CMS floats $30M for QPP measures development

Areas for measure development include safety, care coordination, population health and prevention.

By Meg Bryant • March 6, 2018

State efforts to impose individual mandate going nowhere

Six states and Washington, D.C., have all proposed measures to bring back the individual mandate penalty for health insurance, but so far no legislature has done so.  

By Les Masterson • March 6, 2018

HIMSS18: CMS chief touts EHR, PHR overhaul

Seema Verma said the agency is planning a "complete overhaul" of meaningful use standards for hospitals, but provided few details.

By Kim Dixon • March 6, 2018

Azar says HHS could intervene to 'uncomfortable degree' to achieve value

Speaking at an FAH conference, Azar emphasized giving consumers greater control over their health data and encouraged price transparency from both payers and providers.

By David Lim • March 6, 2018

Arkansas gets Medicaid work requirement

The state has not yet won approval for a part of the proposal to change the income requirement for Medicaid to 100% of the federal poverty level instead of 138% of FPL.

By Les Masterson • March 5, 2018

Patient safety ripe for investment, Frost & Sullivan says

The report predicted that adverse patient safety events in the U.S. and Western Europe will result in about $383.7 billion in healthcare costs over the next four years.  

By Les Masterson • March 5, 2018

Medicaid can be key to tackling social determinants of health

Researchers said adding optional Medicaid benefits, integrating data systems and incorporating social determinants in screening and care delivery can help reduce disparities.

By Les Masterson • March 2, 2018

Trump backs lawsuit against opioid companies

Bipartisan lawmakers are also working on a bill allowing more physicians to prescribe medication-assisted treatment and a restriction on prescriptions.

By David Lim • March 2, 2018

4 questions on Uber's new healthcare platform

There are potentially billions in savings, but little real evidence exists so far.

By Jeff Byers , Shannon Muchmore • March 2, 2018

Network directory errors remain an issue, AMA report finds

Previously, CMS has spoken out about errors in provider directories of Medicare Advantage plans. 

By Les Masterson • Feb. 28, 2018

Association health plans will up ACA market premiums, Avalere says

AHPs are a key part of the Trump administration’s plan to sidestep Affordable Care Act regulations.

By Les Masterson • Feb. 28, 2018

20 states suing to invalidate ACA

The Republican attorneys general are arguing that with the individual mandate penalty zeroed out, it can't be enforced and the law is unconstitutional.

By Shannon Muchmore • Feb. 28, 2018

CVS, Aetna unscathed through congressional hearing

The AMA is asking Congress to "closely scrutinize the pending merger deal" on worries it would reduce competition among PBMs, local health insurance markets and local retail pharmacy markets. 

By David Lim • Feb. 28, 2018