Government: Page 217
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Deep Dive
The Highmark Health gamble: How risky is insurer-hospital integration?
After purchasing a Pennsylvania health system, Highmark Health posted a $186 million loss in 2013 and may lose the leading area provider from its network. What happens next, and what does the Highmark story mean for the trend of vertical integration?
By Judy Packer-Tursman • June 9, 2014 -
It's time to get tougher on patient dumping
Massive fines haven't staunched a really ugly trend with dire consequences.
By Anne Zieger • June 9, 2014 -
Cleveland Clinic CEO Cosgrove says no to VA post
Why did the senior exec decide to stay put? Is it partly to remain in the driver's seat of a Ferrari instead of riding off in an old Rambler?
By Judy Packer-Tursman • June 7, 2014 -
Health care doubles average monthly job growth in May
Economic indicators point to a good start to 2014 for the hospital sector. Will the good news continue?
By Judy Packer-Tursman • June 6, 2014 -
Are hospitals that buy oncology practices grabbing extra profits?
A report says hospitals buying oncology practices have increased their purchases through a federal drug discount program meant for low income Americans — with almost half of such hospitals pocketing savings.
By Judy Packer-Tursman • June 6, 2014 -
Senate confirms Sylvia Burwell as next HHS secretary
Now, Burwell must determine how she wants to steer the organization before a new administration takes over in 2017 — and before the next open enrollment period in 2015.
By Katie Bo Williams • June 5, 2014 -
3M Medicaid applicants stuck in limbo
The Obama administration is boasting the success of Medicaid expansion under reform, but technical glitches and a surge of applications have woefully backlogged enrollment. How will this impact providers?
By Judy Packer-Tursman • June 5, 2014 -
Does the ONC have the authority to regulate health IT?
Republican lawmakers have asked National Coordinator for Health IT Karen Salvo to comment on the extent to which ONC is shifting its focus from coordinating and promoting health IT — to regulating it.
By Anne Zieger • June 5, 2014 -
AHA calls for halt of OIG compliance reviews
Are Office of Inspector General audits "redundant" to the Recovery Audit Contractor program? The AHA thinks so — and claims they are an unfair and expensive burden on hospitals.
By Judy Packer-Tursman • June 5, 2014 -
Are Medicare Advantage plans being overpaid by billions?
Another study says "yes," blaming unjustifiably high risk scoring for plan members — but the industry fires back. Is the increase in risk scores due to MA plans' aggressive billing or a sicker patient population?
By Judy Packer-Tursman • June 5, 2014 -
Medicaid expansion boosts some hospitals' revenue
And the numbers are striking. One hospital in Seattle expects to see an additional $20 million this year alone — double its initial projection.
By Judy Packer-Tursman • June 4, 2014 -
Medicare to cover hepatitis C screening, but not in the hospital
With 17,000 Americans infected annually, CMS wants to protect adults from the virus — if they go to the right care setting.
By Judy Packer-Tursman • June 4, 2014 -
Medicare Advantage bids hint at 2015 changes
Health plans submitting Medicare bids by the June 2 deadline faced tough choices, and the result is shrinking provider networks, premium hikes and benefit cuts.
By Judy Packer-Tursman • June 3, 2014 -
Deep Dive
To AMA, Medicare data too raw to use
Given the legitimate limitations heralded by the organization, what can the data set actually tell health care? More than you might think.
By Katie Bo Williams • June 3, 2014 -
Medicare will now cover sex change surgery
The new rule is the third in a series of HHS decisions this year expanding coverage for the LGBT community. What impact will it have on private payers and Medicare's bottom line?
By Katie Bo Williams • June 3, 2014 -
CMS updates Medicare hospital charge data
The update is part of a suite of new data products released in the name of transparency — but will they be useful?
By Katie Bo Williams • June 3, 2014 -
Doc shortage to blame for Veterans scandal?
As Veterans Affairs hospitals struggle to employ enough primary care physicians to treat their expanding patient base, the department's woes highlight two important industry-wide trends.
By Katie Bo Williams • June 2, 2014 -
Alex Wong via Getty Images
ONC announces reorganization
The restructure has combined 17 offices into 10 new ones in an attempt to "provide a flatter and more accountable reporting structure."
By Katie Bo Williams • June 2, 2014 -
Veterans Affairs secretary Eric Shinseki resigns
The resignation comes in the wake of the ongoing scandal that has uncovered widespread (and sometimes deadly) department inadequacies.
By Katie Bo Williams • May 30, 2014 -
Upcoding to blame for $6.7B in Medicare overpayments?
The OIG concluded that 26% of 2010 claims reflected a higher level of severity than what was justified by the patient's record, indicating a widespread (and very expensive) problem.
By Anne Zieger • May 30, 2014 -
Will boosting transparency cut spending by $100B?
Requiring various stakeholders to disclose prices could have a hefty impact on health care costs, but some studies suggest consumers may not take advantage of the data.
By Anne Zieger • May 27, 2014 -
Industry split over possible meaningful use delay
The AMA says it is concerned about the burden placed on doctors by the upgrades required for Stage 2, but some hospitals call the proposed delay "confusing."
By Randy Lilleston • May 23, 2014 -
Charitable premium subsidies: HHS finally has an answer
The administration will permit third-party payments of premiums — but there are some caveats.
By Katie Bo Williams • May 23, 2014 -
More training is the key to data security says Kaiser officer
The managed care company has had its fair share of breaches and is attempting to improve HIPAA compliance by increasing employee responsibility.
By Anne Zieger • May 22, 2014 -
CMS changes exchange rules to stabilize premiums
The new rule includes some pretty substantive changes, including adjustments to the risk corridors program, tougher navigator standards and others.
By Anne Zieger • May 22, 2014
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