Payers, providers on different pages on SDOH, consumerism, value-based care

"In our 10 years of fielding this research, I don’t think we’ve seen healthcare industry leaders so polarized on some strategic issues," said Change Healthcare SVP David Gallegos, "and so tightly aligned on others."

By Ron Shinkman • Feb. 9, 2020

One Medical's CFO on why primary care is ripe for disruption

The company's IPO was for 17.5 million shares at $14, the low end of its range. On the listing day Jan. 31, shares jumped to about $20. Since then, the stock price has continued to rise.​

By Shannon Muchmore • Feb. 7, 2020

Azar touts 2019 greatest hits, glosses over setbacks in state of HHS speech

He skated over some high-profile efforts from the Trump administration that didn't bear fruit or sparked bad publicity last year, such as efforts to lower drug prices, Medicaid work requirements and cutting away at the ACA.

By Rebecca Pifer Parduhn • Feb. 7, 2020

CMS proposes changes to Part D drug tiers, real-time benefit info for seniors

The proposed rule would also allow patients with end-stage renal disease to enroll in MA plans starting in 2021. Payer groups, however, voiced concerns about the change.

By Samantha Liss • Feb. 6, 2020

FDA greenlights 1st emergency use coronavirus test

The decision means the diagnostic can now be used at any CDC-qualified lab. FDA said several other diagnostic developers are pursuing emergency use authorization.

By Maria Rachal • Feb. 5, 2020

HHS defends forcing hospitals to reveal negotiated rates

The agency took a jab at industry in its rebuttal to hospitals' legal challenge: "If patients pay less for healthcare, however, someone else receives less. Therein lies the genesis of this suit."

By Samantha Liss • Feb. 5, 2020

HHS partners with Regeneron on coronavirus drug development

The agency previously worked with Regeneron on the development and testing of an experimental Ebola treatment that proved effective in the 2018 outbreak of that disease.

By Ned Pagliarulo • Feb. 4, 2020

Hospitals spent $2.5B on social determinant programs from 2017 to 2019

The amount health systems are putting into SDOH initiatives is dwarfed by $60 billion in community benefit spending, but it's nevertheless a "substantial investment," Health Affairs researchers note.

By Shannon Muchmore • Feb. 4, 2020

Payers, providers urge CMS to scrap rule targeting supplemental Medicaid payments

The AHA warned the rule would "severely curtail the availability of health care services to millions" of people and cut Medicaid payments to hospitals by up to $31 billion annually.

By Samantha Liss • Feb. 3, 2020

CMS exchange rules for 2021 target premium subsidies

The agency is also seeking comments on a proposal requiring low-income exchange enrollees who pay no premiums to revisit the exchange during open enrollment to assert they're entitled to the same subsidy the following year.

By Ron Shinkman • Feb. 3, 2020

Payers, employers protest price transparency rule as wrong-headed

Most of the 23,355 public comments expressed skepticism or all-out opposition to the Trump administration's proposal targeting insurers.

By Samantha Liss • Jan. 31, 2020

The Trump administration is offering Medicaid block grants. Which states will say yes?

So far, the governors of Oklahoma and Arkansas have both expressed explicit support for the guidance allowing states to cap payments for adults who became eligible for Medicaid under the 2010 ACA expansion.

By Rebecca Pifer Parduhn • Jan. 30, 2020

Codes for social determinants rarely used, analysis finds

The most frequently used code was for homelessness, followed by problems related to living alone and disappearance and death of a family member, according to CMS.

By Shannon Muchmore • Jan. 30, 2020

Trump admin to allow Medicaid caps, but legal fight likely as providers protest

Providers were quick to attack the highly anticipated plan giving states the option of accepting block grants for payment in the safety-net program, choosing between a per-enrollee or total coverage budget.

By Rebecca Pifer Parduhn • Updated Jan. 30, 2020

Privacy versus access debate rages on, rekindled by Epic lobbying

Promoting interoperability without clear guardrails could lead to healthcare's version of Cambridge Analytica, Epic wrote in a public statement coinciding with ONC's annual health IT conference.

By Rebecca Pifer Parduhn • Jan. 29, 2020

Backing for unique patient identifier picks up steam at ONC conference

The current ban on funding UPIs is "misguided policy," Rep. Bill Foster, D-Ill., said Monday at the gathering of IT and industry officials. But other experts warned it's "not a panacea."

By Rebecca Pifer Parduhn • Jan. 28, 2020

Providers won't be financially liable for info blocking in final ONC rule, due any day

"This final rule won't dive into penalties for providers," the country's health IT chief Don Rucker told Healthcare Dive on the sidelines of the agency's annual conference. "There will be future rulemaking on that."

By Rebecca Pifer Parduhn • Jan. 28, 2020

Practice Fusion pays $145M in 1st criminal action against EHR vendor

DOJ charged the San Francisco-based company, now a subsidiary of Allscripts, with two felony counts for soliciting kickbacks in exchange for using its software to encourage doctors to prescribe more opioids.

By Shannon Muchmore • Jan. 28, 2020

Drug rebates from 340B, Medicaid could be applied twice, GAO finds

Poor oversight of the 340B Drug Discount Pricing Program and the Medicaid Drug Rebate Program may allow providers to improperly receive discounts from both, the watchdog said.

By Hailey Mensik • Jan. 28, 2020

Patient use of digital tools, 3rd-party apps to access health records rises in 2019

One in five patients granted third-party apps access to their health data last year, reviving privacy concerns as the industry waits for HHS to finalize rules setting standards around interoperability.

By Rebecca Pifer Parduhn • Jan. 27, 2020

Providers warned to be vigilant as coronavirus fear spreads

"We want people to have a high index of suspicion and to call if they have a patient they're concerned about," a CDC official said Sunday. Five cases are now confirmed in the U.S., but officials said they expect the number to climb.

By Shannon Muchmore • Jan. 27, 2020

ACA slashed uninsured rate, but number who can't afford care still rising

Between 1998 and 2017, the proportion of the U.S. population unable to see a doctor due to the associated costs of doing so rose from 11.4% to 15.7%, according to a new JAMA Internal Medicine study.

By Ron Shinkman • Jan. 26, 2020

Impeachment trial, election won't dampen health investment, Fitch says

Despite the potential for regulatory changes late in the year, the outlook for healthcare products and services remains strong and the frenetic pace of M&A is unlikely to slow much, according to the ratings agency.

By Rebecca Pifer Parduhn • Jan. 24, 2020

Surescripts loses motion to dismiss FTC antitrust case

The e-prescribing giant argued the regulator's suit is procedurally defective, but a federal judge agreed with the bureau Friday in denying Surescripts' motion to dismiss.

By Rebecca Pifer Parduhn • Jan. 23, 2020

New conservative faction to lobby against benchmark surprise billing fix

The argument against a benchmark rate is popular among provider lobbies, which have spent millions to oppose such proposals — including White House-backed legislation from Senate and House heavyweights.

By Rebecca Pifer Parduhn • Jan. 22, 2020