Payer: Page 150
-
Provider groups ask Medicare Advantage be counted as APM under MACRA in 2019
The groups requested that the agency include MA for the 5% Quality Payment Program bonus in 2019 and 2020.
By Les Masterson • June 5, 2017 -
For-profit hospitals lead the pack of widely varied ED charges
The markups often result in surprise medical bills, which state legislatures are trying to fight.
By Meg Bryant • June 2, 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 -
EHR vendor eClinicalWorks to pay $155M in False Claims Act case
This is the first time an EHR vendor has been held accountable by the government "for failing to meet federal standards designed to ensure patient safety and quality patient care,” a partner at Phillips & Cohen said.
By Meg Bryant • June 1, 2017 -
Freedom Health agrees to pay $31.7M to settle Medicare Advantage whistleblower case
The DOJ said the organization submitted or caused others to submit unsupported diagnosis codes to the CMS and made “material misrepresentations to CMS regarding the scope and content of its network of providers."
By Les Masterson • May 31, 2017 -
AstraZeneca taps outcomes deals to boost cardio, diabetes meds
Two agreements with Harvard Pilgrim for Brilinta and Bydureon will link drug costs to certain patient outcomes — the most recent examples of value-based deals.
By Ned Pagliarulo • May 31, 2017 -
Cleveland Clinic adds big name to VBC task force
The Health Care Transformation Task Force has more than 40 members representing providers, payers, purchasers and patients.
By Shannon Muchmore • May 31, 2017 -
Elizabeth Regan/Healthcare Dive
Skyrocketing chronic diseases will cause major healthcare spending spike
The annual cost of someone with five or more chronic diseases is $45,000, according to a report from the Partnership to Fight Chronic Disease.
By Les Masterson • May 31, 2017 -
UPDATE: DC to hear out MedStar over dropped Medicaid contract pool
A procedural move by D.C. council members will give MedStar 45 days to make its case for the contract.
By Meg Bryant • May 30, 2017 -
Deep Dive
Children's hospitals — and their patients — caught in the crosshairs with planned federal cuts
The proposed funding cuts would increase the rate of uninsured children and burden children’s hospitals with more uncompensated care.
By Les Masterson • May 30, 2017 -
CMS: New Medicare cards combat fraud and illegal use
The cards will use a randomly-assigned Medicare Beneficiary Identifier number instead of a Social Security number.
By Les Masterson • May 30, 2017 -
Optum, Merck announce project to test linking payments to drug effectiveness
The two companies plan to publicly share the results of the multi-year collaboration.
By Les Masterson • May 30, 2017 -
VA set to expand Epic MASS pilot
The agency has been under pressure to replace its outdated patient records system with one that is fully automated.
By Meg Bryant • May 26, 2017 -
California healthcare purchasers team up to tackle the US' $200B medical waste problem
Known as Smart Care California, the coalition is initially focused on reducing elective cesarean sections, opioid use and overtreatment for patients with lower back pain.
By Meg Bryant • May 25, 2017 -
Blues prep opposite plans for ACA exchanges in Mo., NC
Blue Cross NC plans an average 22.9% rate increase if CSRs are not paid, but could also still opt out of the ACA exchanges by the fall. Meanwhile, Blue KC will pull out of the market entirely.
By Les Masterson • May 25, 2017 -
CMS delays bundled payment expansion, again
The cardiac and joint bundled payment programs will now become effective on Jan. 1, 2018.
By Jeff Byers • May 24, 2017 -
California single-payer plan could cost $400B annually
The California Senate Committee on Appropriations said the plan still has uncertainties but would undoubtedly be "an unprecedented change in a large healthcare market."
By Les Masterson • May 23, 2017 -
South Carolina physicians upset over RVU payment plan
The Medical University of South Carolina Hospital will soon pay about 1,000 physicians based on the number of patients they treat rather than how much money each department generates.
By Les Masterson • May 22, 2017 -
Missouri hospital, clinic settle $34M false claims case
Mercy Hospital Springfield and Mercy Clinic Springfield Communities reportedly submitted false claims to Medicare for chemotherapy services.
By Les Masterson • May 22, 2017 -
Deep Dive
Uneasy payers seek more guidance as ACA exchange deadline nears
Payers are waiting to hear whether Republicans will continue to pay cost-sharing reduction payments.
By Les Masterson • May 22, 2017 -
Trump again threatens CSR payments, but delays court case
The White House on Monday asked for another 90-day delay in a lawsuit from House Republicans that argued the CSRs were being illegally funded.
By Shannon Muchmore • May 21, 2017 -
Report: ACA uncertainty hurting healthcare IPOs
Healthcare IPOs have only accounted for 21.1% of all IPOs so far this year, which is a 41.4% drop from last year.
By Les Masterson • May 18, 2017 -
CMS selects 4 more regions for CPC+
The agency expects to have up to 1,000 primary care practices participating in CPC+ Round 2.
By Ana Mulero • May 17, 2017 -
DOJ sues UnitedHealth for alleged Medicare Advantage mischarging, again
The move comes after a former UnitedHealth executive said officials changed diagnosis codes to make patients seem sicker and then collected bonuses.
By Les Masterson • May 17, 2017 -
Oscar Insurance reports lower losses in Q1 versus last year
The insurer lost $25.8 million in the first three months of 2017, which is less than the $48.5 million it lost a year earlier.
By Les Masterson • May 16, 2017 -
Harken Health shuts down after a year of cuts, losses
UnitedHealth started the company in 2015 to test an integrated model that offered primary care visits, mental health counseling and other services with no copays.
By Les Masterson • May 16, 2017
Previous
