3 reasons evidence-based policy is hard

Academics and policymakers gave advice on the challenges to making evidence-based policy at a recent healthcare conference.

By Shannon Muchmore • Feb. 9, 2018

Smorgasbord of health items in massive 2-year budget deal

The agreement staving off an extended government shutdown includes a delay to Disproportionate Share Hospital payment cuts, a repeal of the ACA's Independent Payment Advisory Board and more funding to fight the opioid crisis.

By David Lim • Feb. 9, 2018

Judge rejects whistleblower lawsuit involving Epic billing software

The case was brought by a former compliance review specialist at WakeMed Health.

By Meg Bryant • Feb. 8, 2018

CVS easily beats Q4 forecast, sees Aetna deal on track

CEO Larry Merlo said on an earnings call "nothing that has surfaced" on the Aetna merger bid has come as a surprise, and he still expects the deal to close in the second half of this year.

By David Lim • Feb. 8, 2018

Kansas considers telehealth parity bill

The bill, introduced last month, has strong support from providers and insurers in the state.

By Meg Bryant • Feb. 7, 2018

Management organizations can play key role in ACOs

A Health Affairs report found partnerships helped providers in ACOs with data, administrative, educational and care coordination services.

By Les Masterson • Feb. 7, 2018

Express Scripts: Plan drug spending rose at slowest rate in 24 years

The PBM says its efforts to rein in rising drug costs have helped the plans it administers secure hundreds of millions in savings last year.

By Ned Pagliarulo • Feb. 7, 2018

Intermountain, Geisinger shift focus to patients in revenue cycle

Patients are now a major payer, and providers need to adapt their strategies.

By Les Masterson • Feb. 7, 2018

Humana Q4 earnings a mixed bag

After increasing individual Medicare Advantage membership by only 1% in 2017, the insurer gained more than 3 million members in January. 

By Les Masterson • Feb. 7, 2018

Rideshares fail to reduce patient no-show rates, study shows

A number of hospitals and health systems have partnered with Uber and Lyft in an attempt to help people get to appointments.

By Meg Bryant • Feb. 6, 2018

GAO says assisted living facilities need better oversight by state Medicaid

The agency found 26 state Medicaid agencies could not report the number of critical incidents that occurred in assisted living facilities.

By Les Masterson • Feb. 6, 2018

Expanding ACA plans drove Centene to 8% revenue growth

In announcing its Q4 earnings, the payer raised its guidance for 2018 after a successful open enrollment period in the ACA exchanges. 

By Les Masterson • Feb. 6, 2018

AHIP: 71% satisfied with employer healthcare, 66% say cost unreasonable

“Without a vibrant employer-sponsored marketplace the overall healthcare delivery system would not be able to deliver the services that it is delivering today," said Cigna CEO David Cordani.

By David Lim • Feb. 6, 2018

Slavitt leads bipartisan heavy hitters in health access effort

Newly-formed United States of Care, under former CMS chief Andy Slavitt's leadership, is partnering with Penn LDI to ultimately expand health coverage to all Americans.

By Jeff Byers • Feb. 6, 2018

How to make population health pop: What experts say

Barriers to successful pop health initiatives include quantifying and monetizing health information that may not lend itself to such analysis and getting organizations with different priorities to work together.

By Shannon Muchmore • Feb. 6, 2018

Varied uptake in e-consults at New England VA facilities: Health Affairs

The researchers looked at use of anesthesiology e-consults for preoperative evaluation.

By Meg Bryant • Feb. 6, 2018

Highest healthcare spenders vary each year

The top 5% of healthcare spenders in 2015 accounted for 53% of spending, a new Health Care Cost Institute analysis found.

By Les Masterson • Feb. 5, 2018

Medicaid work requirements bring uncertainty to hospital bottom lines, Fitch warns

Kentucky has already received a Medicaid waiver that allows it to implement work requirements, and seven more states could follow shortly.

By Meg Bryant • Feb. 2, 2018

UPDATE: Indiana Medicaid work waiver approved

The Trump administration is giving states more flexibility in running Medicaid, but critics say some changes restrict access to care for the most needy.

By Les Masterson • Feb. 2, 2018

DOJ seeks more info on proposed CVS, Aetna merger

CVS did not say what information DOJ is seeking, but the request is not unexpected.

By Shannon Muchmore • Feb. 2, 2018

Medicare Advantage plans to see 1.84% rate bump

CMS is also proposing opioid prescribing limits starting in 2019 for Part D plans to help stem the opioid crisis.

By David Lim • Feb. 2, 2018

Changes from DC could mean a difficult year ahead for hospitals

​Issues facing hospitals this year include Medicaid DSH cuts, a possible return of mandatory bundling initiatives and CMS potentially moving hip replacement procedures to outpatient.  

By Les Masterson • Feb. 1, 2018

Cigna revenue, membership up with commercial focus

Medicare Advantage membership growth is also expected to increase by 3% in 2018 and will likely accelerate in 2019.  

By Les Masterson • Feb. 1, 2018

Oscar reports 32% rise in members' telehealth use

Two-thirds of members’ medical encounters in 2017 occurred virtually.

By Meg Bryant • Feb. 1, 2018

Physician practices not flocking to CPC+

Just 165 practices have signed up to participate in round two of the CMS public-private partnership.

By Meg Bryant • Jan. 31, 2018