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

Medicare out-of-pocket costs seen rising to half of senior income

Older people in poor health, women and lower-income Americans are paying higher percentages of their per capita income on out-of-pocket Medicare costs.  

By Les Masterson • Jan. 30, 2018

Amazon, JPM, Berkshire form new company to tackle health costs

The corporate giants gave few details about the new venture, but said the initial focus will be technology solutions to provide their stateside employees with high-quality, low-cost healthcare.

By Shannon Muchmore • Jan. 30, 2018

Medicare Advantage membership grows almost 8%

The market is still dominated by a handful of payers and online provider directory errors remain a problem for MA.  

By Les Masterson • Jan. 30, 2018

Meaningful use most helpful for routine care: survey

A 2015 survey of 480 family physicians found that 18 of 31 MU criteria were considered useful for more than half of patient encounters, with 13 of those useful for more than two-thirds.  

By Les Masterson • Jan. 29, 2018

Most hospitals will see Part B revenue increase despite 340B cut

The findings from Avalere come as hospitals challenge the 340B drug payment cut in court.

By David Lim • Jan. 29, 2018

CMS cost measure makes some Medicare Advantage plans pricier

The authors of a new Health Affairs analysis suggest limiting benchmark cost data to Medicare beneficiaries enrolled in both Part A and Part B. 

By Meg Bryant • Jan. 26, 2018

New York, Minnesota sue Trump administration over Basic Health Plan cuts

Both state's attorneys general say the HHS is withholding legally-required funding owed to the states.

By Les Masterson • Jan. 26, 2018

HHS touts regulatory rollbacks under Trump's first year

A 37-page report highlights priorities for the Trump administration, most of which have sharply divided the industry.

By Shannon Muchmore • Jan. 26, 2018

One Brooklyn Health wins $664M to develop 32-site ambulatory network

"This holistic investment creates a sustainable, unified health care system to empower historically underserved communities, support health and wellness and ensure a brighter future for the people of Brooklyn," New York Gov. Andrew Cuomo said.

By David Lim • Jan. 26, 2018

Medicaid could play key role in addressing social factors in healthcare

Many Medicaid programs collect data for social determinants of health, but not often in an organized way, according to a report from the National Qualify Forum.

By Les Masterson • Jan. 26, 2018

Blue Cross of North Carolina opposes Carolinas-UNC merger

In a letter to the two health systems, BCBS CEO Dr. Patrick Conway said the deal would increase patient costs.

By Shannon Muchmore • Jan. 25, 2018

Pent-up needs may fuel Medicaid expansion costs: Avalere

In other Medicaid news, a group of Kentucky residents is suing HHS over the recent work requirement waiver. 

By Les Masterson • Jan. 24, 2018

Azar confirmed as HHS secretary in bipartisan vote

The former Eli Lilly executive, attacked by some critics as too cozy with the pharmaceutical industry, has said he will make drug prices a top priority and has expressed openness to mandatory bundles.

By David Lim • Jan. 24, 2018

ACA helped reduce out-of-pocket costs: JAMA

Many low-income Americans, however, still face high out-of-pocket costs.  

By Les Masterson • Jan. 24, 2018

CMS, VA to share data to prevent healthcare fraud

The partnership is the latest in federal agency steps to increase healthcare fraud and misuse prevention efforts.

By Jeff Byers • Jan. 24, 2018