Policy & Regulation: Page 2
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CMS sets goals to tackle opioid crisis
The plan calls for greater data transparency and interoperability and use of the Medicare heat map to pinpoint areas that can benefit from targeted safe prescribing efforts.
By Meg Bryant • June 12, 2018
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Wide spectrum of patients see better outcomes at academic medical centers, study finds
Authors of the Health Affairs report said they were surprised that even among less sick patients, the centers had better outcomes.
By Les Masterson • June 11, 2018
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Fixing provider directories a low-risk way to test blockchain, report suggests
UnitedHealth, Humana and Quest Diagnostics are among those working on a pilot blockchain project to update provider directories.
By Les Masterson • June 11, 2018
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ED visits increased nearly 10% in California after ACA
A Health Affairs study also found the chance of a Medicaid enrollee being a frequent ED user was "significantly lower" after the Affordable Care Act was signed into law.
By Les Masterson • June 08, 2018
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DOJ argues ACA pre-existing condition, individual mandates unconstitutional
The Trump administration said that with Congress zeroing out the penalty starting in 2019, the health law's individual mandate, community rating and guaranteed issue provisions cannot stand.
By David Lim • UPDATED: June 8, 2018 at 1:10 p.m.
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Reduction in hospital-acquired conditions saved $2.9B over 2 years
An Agency for Healthcare Research and Quality report found improved patient safety in 2015 and 2016 prevented about 8,000 deaths.
By Les Masterson • June 07, 2018
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Study raises concerns about Medicaid managed care's narrow networks
A Health Affairs report said states need to make sure that physician turnover in narrow network plans doesn't create issues with doctor continuity for vulnerable populations.
By Les Masterson • June 07, 2018
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BIO18: FDA to issue guidance on cell and gene therapy in July
Commissioner Scott Gottlieb also said the industry needs to move toward continuous manufacturing of these treatments.
By Lisa LaMotta • June 07, 2018
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NIH lays out strategic plan for evolving field of data science
In particular, it points to the rapid growth of EHR and genomic data.
By Meg Bryant • June 06, 2018
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Bucking national trend, Pennsylvania payers seek modest exchange premium hikes
While many states worry there will be less competition in the individual market next year, Pennsylvania is seeing an uptick of participation in the exchange.
By Les Masterson • June 06, 2018
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Medicaid expansion improved care access and coverage, analysis finds
More than 30 states have expanded Medicaid under the ACA, and a few more will have the issue up for a vote this fall.
By Les Masterson • June 06, 2018
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Mandatory CMS bundles showed advantages over voluntary initiatives, report finds
A Health Affairs report found mandatory and voluntary bundled payment models "engaged different types of hospitals."
By Les Masterson • June 06, 2018
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CMS announces new Medicaid transparency tool
State Medicaid directors said they are concerned about the "comparability, accuracy and timeliness of the data" and said differences in care delivery approaches from state to state might be lost in translation.
By Tony Abraham • June 05, 2018
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Losing ACA mandate penalty will reverse coverage gains, report finds
A Brookings analysis that focused on those not eligible for ACA subsidies found the individual mandate was the major reason the group got insured.
By Les Masterson • June 04, 2018
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AMA trumpets physician efforts in opioid epidemic fight
The doctors' group said opioid prescriptions are down while prescription drug monitoring program queries are up.
By Les Masterson • June 01, 2018
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Trump administration pushes 340B ceiling price rule to 2019
It is the fifth delay for the rule, which would also set a penalty for drugmakers that overcharge participating hospitals.
By Tony Abraham • June 01, 2018
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Healthcare pricing transparency remains elusive, study finds
A JAMA Network survey found that even fewer hospitals provided pricing information in 2016 than did for a similar study four years earlier.
By Les Masterson • May 31, 2018
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Deep DiveDays of information blocking look numbered
Government pressure and emerging business incentives are encouraging companies to share data.
By Meg Bryant • May 31, 2018
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Healthcare groups mixed on proposed direct provider contracting model
Some groups support DPC as a way to increase access to alternative payment models, but others fear it is too redundant and encouraged CMS to fix other programs instead.
By Les Masterson • May 30, 2018
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Virginia on cusp of expanding Medicaid
The state Senate on Wednesday moved past the most significant hurdle to expand Medicaid to an additional 400,000 residents, a long-sought goal of Democrats using the powers under the Affordable Care Act.
By David Lim • UPDATED: May 31, 2018 at 9:14 a.m.
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Readmission rates among BPCI episodes show room for improvement
Groups mulling participation in the Bundled Payment for Care Improvement Advanced model may find success in targeting certain high readmission rates, according to a new report from Avalere.
By Shannon Muchmore • May 30, 2018
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ACA health insurance tax would be delayed 2 years under bipartisan bill
Insurance companies say ending the tax would let them reduce premiums by 3%.
By Les Masterson • May 29, 2018
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Medicaid expansion sees movement in Virginia, may get vote in Idaho
Virginia could become the next state to expand Medicaid, with the state legislature expected to vote in the coming days on a plan that would tax hospitals to fund the added coverage.
By Les Masterson • May 29, 2018
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California to hospitals: 'Time's up' on unnecessary procedures
Covered California is threatening to oust hospitals with high C-section rates from participating health plans' provider networks.
By Meg Bryant • May 25, 2018
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Comments criticize CMS plan to cut Medicaid care access monitoring
Healthcare officials said the change could especially hurt rural hospitals and force facilities to take lower rates without any recourse.
By Les Masterson • May 24, 2018