Payer: Page 143
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Healthcare industry split on CMS' proposal to allow inpatient joint replacement surgeries
Providers at hospitals, which would see less revenue under the plan, say moving those procedures to outpatient settings would threaten patient safety.
By Les Masterson • Sept. 14, 2017 -
Centene expands NY market share with $3.8B Fidelis Care acquisition
Following the announcement, Centene's stock hit an all-time high.
By Jeff Byers • Sept. 13, 2017 -
Explore the Trendline➔
Yujin Kim/Healthcare Dive
TrendlinePayer/provider relationships
As M&A intensifies and companies embrace more holistic and value-based care models, partnerships have become more closely intertwined.
By Healthcare Dive staff -
Hospital groups oppose 340B cuts, site neutral payments in comments to CMS
The AHA suggested CMS suspend the star ratings program and electronic clinical quality measure reporting requirements as well as cancel Stage 3 of the Meaningful Use program.
By Shannon Muchmore • Sept. 13, 2017 -
Census shows uninsured rate drops to new record low
Medicare was the only health insurance subtype that saw a “statistically significant difference” between 2015 and 2016.
By Les Masterson • Sept. 13, 2017 -
WSJ: Hospitals often retain accreditation despite safety violations
According to the newspaper's analysis of inspection reports, about 350 hospitals maintained accreditation in 2014 despite Medicare deviations, and more than a third of those had further violations in 2015 and 2016.
By Meg Bryant • Sept. 12, 2017 -
Most patients want to know costs, financing options before treatment
A HealthFirst Financial survey finds more than half of respondents said they would like healthcare providers to discuss financial options before care.
By Les Masterson • Sept. 12, 2017 -
Telehealth could lure more providers to ACOs
At a recent MedPAC meeting, members noted Medicare telehealth payments are increasing, but usage is low overall and dominated by a small number of providers and beneficiaries.
By Meg Bryant • Sept. 12, 2017 -
Altarum creates value-based health benefit plan
The Medical Episode Spending Allowance Plan is geared for people with chronic or serious health conditions.
By Les Masterson • Sept. 12, 2017 -
CBO: Medicare spending has slowed this fiscal year
The agency also reported that subsidies paid to health insurance companies through the ACA marketplace rose by 25%.
By Les Masterson • Sept. 11, 2017 -
Major industry groups, state officials push Congress for CSR payments
A lack of commitment to cost-sharing reduction payments has led to more payers pulling out of exchange markets and requesting large premium increases for 2018.
By Les Masterson • Sept. 11, 2017 -
CareFirst can take data breach case to Supreme Court
If the high court accepts the case, it will be its first on data breach issues.
By Meg Bryant • Sept. 8, 2017 -
Elizabeth Regan/Healthcare Dive
Physicians say more than a fifth of all medical care is unnecessary
Fear of malpractice is the most common reason for overtreatment.
By Meg Bryant • Sept. 8, 2017 -
Altarum: Hospital spending growth rate lowest in 28 years
Year-over-year hospital spending increased 1.1% in July, which was the slowest growth in any major healthcare category.
By Les Masterson • Sept. 8, 2017 -
Online physician ratings fail to adequately provide quality information
Cedars-Sinai Medical Center researchers said online ratings should not be used solely to select doctors.
By Les Masterson • Sept. 8, 2017 -
Deep Dive
Why scaling back bundled payment programs won't stop the shift to alternative models
Big changes to CMS' bundled payment programs could have immediate and long-term effects, but value-based care remains a bipartisan movement that won't be easily stopped.
By Shannon Muchmore • Sept. 6, 2017 -
ACA supporters forming to promote open enrollment in place of HHS
The ACA exchange marketplaces continue to fluctuate as payers look to a busy Congress for assurance of cost-sharing reduction payments.
By Shannon Muchmore • Sept. 6, 2017 -
Study: Concentrated insurer markets lead to lower hospital, physician prices
The lower prices did not result in reduced costs for members, however.
By Les Masterson • Sept. 6, 2017 -
Deep Dive
Independent Payment Advisory Board still in Congress' crosshairs
Medicare spending hasn't yet reached the level to activate IPAB, which ACA opponents mischaracterized as a "death panel." Most of the healthcare industry supports stopping it before it starts.
By Les Masterson • Sept. 5, 2017 -
Bipartisan group of governors release ACA market stabilization plan
The plan, which encourages more consumer participation in ACA marketplaces, comes as HHS announced a dramatic 90% cut to the ACA advertising budget.
By Shannon Muchmore • Sept. 1, 2017 -
More than 3% of ED visits are avoidable, study shows
The authors suggest addressing gaps in the healthcare system to reduce the unnecessary visits, which are most often connected to mental health and dental conditions.
By Les Masterson • Sept. 1, 2017 -
Medicare payments for telehealth up 28% last year
The increase in payments was fueled by a 33% jump in telehealth claims.
By Meg Bryant • Aug. 31, 2017 -
Government report says ACOs in MSSP 'show promise'
Most of the ACOs in the Medicare Shared Savings Program reduced spending and improved care quality, but a few dozen stood out substantially as high performers.
By Shannon Muchmore • Aug. 31, 2017 -
NorthBay Healthcare accuses Kaiser Permanente of underpaying for ED care
NorthBay alleges Kaiser conducted an "anti-competitive conspiracy," but Kaiser says it offers fair and reasonable rates.
By Les Masterson • Aug. 31, 2017 -
Percentage of uninsured Americans drops slightly to 8.8%
A government report also shows more people using high-deductible plans, which typically lead to increased out-of-pocket costs.
By Les Masterson • Aug. 30, 2017 -
OIG: CMS not doing enough to protect nursing home patients
The watchdog office found 134 cases of potential abuse or neglect in a one-year period among Medicare beneficiaries in skilled nursing facilities nationwide.
By Meg Bryant • Aug. 29, 2017
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