Government: Page 155
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Study: Improving quality reduces readmissions, but doesn't lead to consistent savings
Cedars-Sinai researchers found quality improvement programs saved health systems an average $972 per heart failure patient but lost a net average $169 per person for other patients.
By Les Masterson • June 1, 2017 -
Freedom Health agrees to pay $31.7M to settle Medicare Advantage whistleblower case
The DOJ said the organization submitted or caused others to submit unsupported diagnosis codes to the CMS and made “material misrepresentations to CMS regarding the scope and content of its network of providers."
By Les Masterson • May 31, 2017 -
Latest on the AHCA is mostly talk
Republican Senate aides are said to be drafting the upper chamber’s version of the bill to replace the ACA this week, but there is no indication that progress is being made on sticking points such as Medicaid funding and coverage for people with pre-existing conditions.
By Shannon Muchmore • May 31, 2017 -
Elizabeth Regan/Healthcare Dive
Skyrocketing chronic diseases will cause major healthcare spending spike
The annual cost of someone with five or more chronic diseases is $45,000, according to a report from the Partnership to Fight Chronic Disease.
By Les Masterson • May 31, 2017 -
Deep Dive
Children's hospitals — and their patients — caught in the crosshairs with planned federal cuts
The proposed funding cuts would increase the rate of uninsured children and burden children’s hospitals with more uncompensated care.
By Les Masterson • May 30, 2017 -
CMS: New Medicare cards combat fraud and illegal use
The cards will use a randomly-assigned Medicare Beneficiary Identifier number instead of a Social Security number.
By Les Masterson • May 30, 2017 -
Blues prep opposite plans for ACA exchanges in Mo., NC
Blue Cross NC plans an average 22.9% rate increase if CSRs are not paid, but could also still opt out of the ACA exchanges by the fall. Meanwhile, Blue KC will pull out of the market entirely.
By Les Masterson • May 25, 2017 -
Taylor McKnight/Healthcare Dive
CBO: Amended AHCA would still leave 23M uninsured
The agency found that premiums for single policyholders buying in the nongroup market would increase by an average of about 20% in 2018 and 5% in 2019.
By Shannon Muchmore • May 24, 2017 -
Deep Dive
Trump's policies are pressing doctors to speak out
"I think a lot of providers are really beginning to understand that these policies are a direct threat to the patients we serve,” says Dr. Manik Chhabra, a primary care physician in Philadelphia.
By Meg Bryant • May 24, 2017 -
CMS delays bundled payment expansion, again
The cardiac and joint bundled payment programs will now become effective on Jan. 1, 2018.
By Jeff Byers • May 24, 2017 -
California single-payer plan could cost $400B annually
The California Senate Committee on Appropriations said the plan still has uncertainties but would undoubtedly be "an unprecedented change in a large healthcare market."
By Les Masterson • May 23, 2017 -
Deep Dive
Uneasy payers seek more guidance as ACA exchange deadline nears
Payers are waiting to hear whether Republicans will continue to pay cost-sharing reduction payments.
By Les Masterson • May 22, 2017 -
Report: ACA uncertainty hurting healthcare IPOs
Healthcare IPOs have only accounted for 21.1% of all IPOs so far this year, which is a 41.4% drop from last year.
By Les Masterson • May 18, 2017 -
CMS selects 4 more regions for CPC+
The agency expects to have up to 1,000 primary care practices participating in CPC+ Round 2.
By Ana Mulero • May 17, 2017 -
DOJ sues UnitedHealth for alleged Medicare Advantage mischarging, again
The move comes after a former UnitedHealth executive said officials changed diagnosis codes to make patients seem sicker and then collected bonuses.
By Les Masterson • May 17, 2017 -
Trump issues cybersecurity executive order amid rising threats
The executive order requires all government agencies to modernize their IT systems.
By Meg Bryant • May 16, 2017 -
NJ governor moves for more control over profits of state's largest payer
Horizon Blue Cross Blue Shield of New Jersey reportedly rebuffed Gov. Chris Christie's request to give $300 million to the state’s addiction-treatment fund.
By Les Masterson • May 16, 2017 -
Deep Dive
What the last nail in the Anthem-Cigna coffin means for the healthcare industry
The end of the Anthem-Cigna merger gives other large payers "a chance to see how the Trump administration redefines the rules of the game,” Michael Abrams, managing partner at Numerof & Associates, told Healthcare Dive.
By Ana Mulero • May 15, 2017 -
ONC announces new deputy health IT coordinator
Genevieve Morris has worked in the health IT field for more than 10 years.
By Les Masterson • May 14, 2017 -
More than 800K physicians get MACRA reporting reprieve for 2017
The change came after the CMS used an updated formula to estimate providers' Medicare revenue.
By Les Masterson • May 14, 2017 -
Cigna could soon end proposed $54B Anthem merger after latest court ruling
"We look forward to closing this final chapter,” a Cigna representative said. A Delaware court on Thursday denied Anthem's request to block Cigna from terminating the merger.
By Ana Mulero • May 11, 2017 -
Deep Dive
MACRA: Why cloud-based solutions could be the answer for small practices
Most (80%) of the medical practices with 15 physicians or fewer that were recently surveyed by Healthcare Informatics said they were not ready for MACRA or needed help.
By Meg Bryant • May 11, 2017 -
Feds would need to modify risk adjustment program if changes are made to ACA exchanges
The American Academy of Actuaries said some of the changes could include “major structural modifications.”
By Les Masterson • May 11, 2017 -
Senate confirms Scott Gottlieb as FDA chief
Gottlieb will have to strike a balance between the Trump administration's push to deregulate and defending the FDA's "gold standard" for reviewing the safety and efficacy of new drugs.
By Ned Pagliarulo • May 10, 2017 -
BCBS of TN steps forward to fill ACA exchange gap
The insurer said it will participate in ACA exchanges covering 16 eastern Tennessee counties that currently have no payer in place for next year.
By Les Masterson • May 9, 2017
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