Providers make efforts, but cuts to low-value care elusive

Healthcare stakeholders know they should cut low-value services, but there are multiple obstacles to overcome.  

By Les Masterson • Jan. 24, 2018

New York proposes Medicaid payment cuts to payers with large reserves

Gov. Andrew Cuomo is also suggesting a 14% tax on for-profit payers and requesting New York get "a cut of the proceeds when nonprofit insurers convert to for-profit companies."  

By Les Masterson • Jan. 23, 2018

Medicaid buy-in could expand choices, lower premiums for a few states

The Urban Institute analyzed a buy-in proposal backed by Democrats eyeing a 2020 run.   

By Les Masterson • Jan. 23, 2018

CHIP renewed 6 years, ACA taxes delayed under spending pact

Congress will need to approve another spending bill by Feb. 8, and it may include additional healthcare measures. 

By Les Masterson • Jan. 23, 2018

EHRs can nudge docs toward prescribing fewer opioids, study finds

The University of Pennsylvania School of Medicine created a default system that physicians could overrule to prescribe more tablets, but the report found fewer opioids prescribed above the default limit.  

By Les Masterson • Jan. 22, 2018

Providers go deeper with population health, weighing social factors

Healthcare organizations are waking up to the importance of social determinants of health, like housing and nutrition.

By Les Masterson • Jan. 22, 2018

UPDATED: Shutdown ends after half of HHS staff furloughed

Congress voted to fund the government until Feb 8.

By David Lim • Jan. 22, 2018

VA proposal looks to ease EHR exchanges with private providers

Under the suggested rule, outside providers would no longer be required to have a physical copy of consent from a VA patient to obtain EHR data from the VA.

By Les Masterson • Jan. 22, 2018

Rural hospitals need flexible policies to survive, report says

The paper called for opportunities that let rural communities define their own needs and service sets, including transforming some hospitals from small inpatient care centers to new models like rural emergency centers.

By Meg Bryant • Jan. 18, 2018

Trump creates HHS Conscience and Religious Freedom unit, sparking protest

Many are worried the new division will give physicians permission to refuse to perform services such as abortion or sex reassignment surgeries.

By Jeff Byers • Jan. 18, 2018

Trump administration plans review of Stark Law regulations

An inter-agency working group will consider ways to revise the anti-kickback law. 

By Les Masterson • Jan. 18, 2018

Pharma, payers clash over CMS Part D drug rebate plan

The drug, pharmacy benefit managers and insurance industries are squabbling over a CMS proposal to require Part D sponsors to pass on a percentage of rebates to consumers.

By David Lim • Jan. 18, 2018

Hospitals, payers and docs collaborate on prior authorization

Trade groups for major healthcare players say they share a "commitment to industry-wide improvements to prior authorization processes and patient-centered care."  

By Les Masterson • Jan. 17, 2018

Uninsured rate in 2017 had biggest increase in a decade

The rate increased in all demographic groups except for senior citizens, but went up most for young adults, blacks, Hispanics and low-income Americans.   

By Les Masterson • Jan. 17, 2018

FDA works to ease IV shortages after Hurricane Maria

U.S. saline and drug shortages are still challenging.

By Suzanne Elvidge • Jan. 17, 2018

Kentucky first to try Medicaid work requirement

Allowing states to require work is one way the Trump administration is looking to reduce the size of Medicaid. 

By Les Masterson • Jan. 15, 2018

Trump administration had own plan to sabotage ACA

A Democratic senator made public a document from March that outlines a plan to use executive orders and policy changes to take apart the ACA.  

By Les Masterson • Jan. 12, 2018

Trump admin's new bundle bid shows value-based care's staying power

Advocates of value-based payment reform breathed a sigh of relief last week when CMS announced a new bundled payment model.

By Shannon Muchmore • Jan. 12, 2018

FDA lays out digital health goals in 2018 strategic roadmap

The agency will continue to build out its Pre-Certification Pilot Program to help encourage the development of digital health tools.

By David Lim • Jan. 12, 2018

Loss of net neutrality could slow telehealth access

"The ability for hospitals to access internet service providers and bandwidth is a 'has to' in healthcare," says Eagle Telemedicine COO Robert Annas.

By Meg Bryant • Jan. 11, 2018

AHA, health systems appeal 340B decision

The House Energy & Commerce Committee issued a report Wednesday that offered a series of suggestions to improve oversight of the program that gives drug discounts to some hospitals.   

By Les Masterson • Jan. 11, 2018

CMS goes all in on Medicaid work requirements

At least ten states are considering section 1115 Medicaid waivers that require enrollees to have a job, train for a job or participate in community activities like volunteer work.

By Shannon Muchmore • Jan. 11, 2018

ACOs flock to Medicare Shared Savings Program

Most of the ACOs in a risk-based contract chose Track 1+, which is the latest risk model.   

By Les Masterson • Jan. 11, 2018

CMS extends Maryland all-payer program for another year

Maryland is working with the agency on a larger proposal to include outpatient services.  

By Les Masterson • Jan. 10, 2018

Payers with ACA plans expected to have relatively strong year

Experts predict a fairly stable 2018 for the individual market, as long as Congress doesn't try another "repeal and replace" effort or make more moves that might destabilize the exchanges. 

By Les Masterson • Jan. 10, 2018