Payer: Page 104


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    ONC to Congress: Room for improvement in data sharing

    Ongoing barriers to seamless data sharing range from technical and financial to trust and business practices, according to the HHS IT department's latest progress report.

    By Jan. 10, 2019
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    Few digital health companies studying impact in high-burden populations, study finds

    Only 16 of the more than 100 studies the authors looked at assessed a digital health product's impact on outcomes, and none measured its effect on cost or access to care, according to the report in Health Affairs.

    By Jan. 10, 2019
  • Government shutdown poses another hiccup for CVS-Aetna

    CVS CEO Larry Merlo addressed the ongoing court review of the Aetna merger at J.P. Morgan's annual conference, saying it will not impede expected benefits from the marriage.

    By Jan. 10, 2019
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    Danielle Ternes
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    Deep Dive

    How AI could shape the health tech landscape in 2019

    Highlights include technologies that seek to cut costs and promote patient health, especially in the areas of imaging, diagnostics, predictive analytics and administration.

    By Jan. 10, 2019
  • Grassley to zoom in on drug pricing, insurance mergers as Senate panel chair

    The new Republican chairman of the Senate Finance Committee pledged to scrutinize mergers such as the CVS-Aetna deal and work to allow cheaper drug imports from Canada.

    By David Lim • Jan. 10, 2019
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    Sponsored by ZS

    Even without the final stamp of approval, CVS/Aetna can start preparing for the work that lies ahead

    3 ways the CVS/Aetna merger can make healthcare consumers happier.

    By Peter Manoogian • Jan. 10, 2019
  • Medicare joint replacement program could succeed in more regions, Health Affairs study says

    The mandatory bundled payment model first implemented in 2016 has shown some ability to cut spending without negatively affecting care quality.

    By Les Masterson • Jan. 9, 2019
  • JPM19: Bluebird proposes installment plan for LentiGlobin gene therapy

    The biotech company would receive further payments only if LentiGlobin keeps working, according to a theoretical payment scheme the company rolled out Tuesday.

    By Kristin Jensen • Jan. 9, 2019
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    High-cost Medicare patients more likely to be younger, low-income

    One of the greatest predictors of a high-cost patient was whether they are dually eligible due to chronic kidney disease.

    By Jan. 9, 2019
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    Women make up only 13% of healthcare CEOs

    On average, it takes women three to five years longer than men to reach the top executive position, according to a report from Oliver Wyman.

    By Jan. 8, 2019
  • JPM19: Molina CEO confronts 'misperceptions'

    At the annual conference Monday, CEO Joseph Zubretsky touted areas of growth, pointing to $1 billion in revenue opportunities this year in the payer's existing portfolio.

    By Jan. 8, 2019
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    House Democrats hope to push all states to expand Medicaid

    Meanwhile, some Republicans in D.C. support a partial Medicaid expansion for the 14 states that have not yet opened up their programs to include more residents.

    By Les Masterson • Jan. 8, 2019
  • Centene inks deal to buy Arkansas health plan from CHI

    The hospital chain has wanted to divest its insurance business for years, part of its ongoing plan to focus more on value-based payments and population health.

    By Jan. 7, 2019
  • Cancer treatment choices may be skewed by financial incentives, study shows

    Physicians in freestanding radiotherapy centers were more likely to self-refer radiation treatment for patients, according to the report in JAMA Oncology.

    By Jan. 4, 2019
  • Hospitals see 'modest' 3% savings using Medicare joint replacement model, study finds

    Those participating didn't see a significant difference in complications or percentage of procedures among high-risk patients, according to the report in the New England Journal of Medicine.

    By Les Masterson • Jan. 4, 2019
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    Final ACA federal enrollment tally drops due to cancellations

    The final numbers are roughly 43,000 lower than those CMS posted at the end of open enrollment last month and about 4% lower than figures a year ago.

    By Jan. 4, 2019
  • Court rejects 340B payment cuts in big win for hospitals

    The district court judge asked the federal government and hospitals to come to an "appropriate remedy."

    By Les Masterson • Dec. 31, 2018
  • CMS unveils 'new direction' for MSSP that adds more risk on ACOs

    The change also includes new beneficiary incentives, telehealth services and beneficiary assignment methodology choices.

    By Les Masterson • Dec. 28, 2018
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    JAMA findings suggest 'unintended harm' from Hospital Readmissions Reduction Program

    The study shows an association between the program and 30-day post-discharge mortality in heart failure patients.

    By Dec. 21, 2018
  • CMS proposes changes to risk adjustment payments for MA plans

    The payment changes would go into effect in 2020. CMS is now seeking public comments.

    By Dec. 21, 2018
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    Humana signs up first health systems for new value-based contracting program

    The inaugural participants are Cleveland Clinic Florida, Jackson Health System in Florida, TriHealth in Ohio and WellStar Health System in Georgia.

    By Les Masterson • Dec. 20, 2018
  • Walgreens teams up with Alphabet's Verily on medication adherence pilot

    The two companies said they are seeking to improve care for those with chronic conditions such as Type 2 diabetes.

    By Dec. 20, 2018
  • ACA federal exchange enrollment drops about 4%

    The slump is not as significant as many had feared, and shows the law is "far from dead," said Kaiser Family Foundation's Larry Levitt.

    By Les Masterson • Dec. 20, 2018
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    Study finds 'mixed messages' in Medicare hospital ratings, penalty programs

    The report echoes other findings that question the usefulness of hospital rankings.

    By Dec. 19, 2018
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    ACA ruling could upend Medicaid expansion

    Policy experts say it's hard to overstate the chaos the ruling would create if it stands, although many legal scholars doubt it will be upheld. Still, some managed care companies have contingency plans.

    By Dec. 19, 2018