Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week: 

Federal Shutdown Mostly Spares Health Coverage, But Other Issues Loom

As the partial government shutdown drags on, about 800,000 federal employees who work for the shuttered agencies — and their families — are facing the reality of life without a paycheck.

Kaiser Health News

Friday, January 11, 2019

As Congress returns, lawmakers rush to detail drug-pricing agendas

Chuck Grassley wasted little time this week in unveiling his drug-pricing agenda, attaching his name to a trio of bills that, as the new chair of the Senate Finance Committee, he is freshly empowered to advance.

Stat News

Thursday, January 10, 2019

Medicaid ‘Buy-In’ Could Be a New Health Care Option for the Uninsured

Even as calls for “Medicare for All” grow louder among Democrats in Washington, D.C., at least 10 states are exploring whether to allow residents to pay premiums to “buy in” to Medicaid, the federal-state health care program for the poor.

Pew Trust

Thursday, January 10, 2019

Health Care Industry Spends $30B A Year Pushing Its Wares, From Drugs To Stem Cell Treatment

Hoping to earn its share of the $3.5 trillion health care market, the medical industry is pouring more money than ever into advertising its products — from high-priced prescriptions to do-it-yourself genetic tests and unapproved stem cell treatments.

Kaiser Health News

Tuesday, January 8, 2019

At glitzy Vegas tech show, chronic-disease gadgets to take center stage

An exploding array of digital health companies will converge on Las Vegas this week to showcase the latest advances in using data and algorithms to try to solve the world’s toughest health problems.

Stat News

Monday, January 7, 2019 

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week: 

As Hospitals Post Sticker Prices Online, Most Patients Will Remain Befuddled 

As of Jan. 1, in the name of transparency, the Trump administration required that all hospitals post their list prices online.

Kaiser Health News

Friday, January 4, 2019

Bristol-Myers to Acquire Celgene in Deal Worth $74 Billion

Bristol-Myers Squibb said on Thursday that it would buy Celgene, a maker of cancer-fighting drugs, in a cash-and-stock deal valued at $74 billion, the first major pharmaceutical deal of 2019.

NY Times

Friday, January 4, 2019

Drug companies greet 2019 with U.S. price hikes

Drugmakers kicked off 2019 with price increases in the United States on more than 250 prescription drugs, including the world’s top-selling medicine, Humira, although the pace of price hikes was slower than last year.

Reuters

Thursday, January 3, 2019 

Ransomware, phishing attacks top new HHS list of cyberthreats in healthcare

Email phishing attacks, ransomware attacks and attacks against connected medical devices are among the greatest cyberthreats that health systems need to protect against, according to new cybersecurity guidance for health systems from the Department of Health and Human Services.

Fierce Healthcare

Wednesday, January 2, 2019

Link between readmission rates, mortality rates back under scrutiny

A new study shows a statistically significant correlation between lower readmission rates and higher mortality rates for patients with heart failure and pneumonia, renewing questions about the efficacy of the Center for Medicare and Medicaid Services' Hospital Readmissions Reduction Program (HRRP).

Fierce Healthcare

Wednesday, January 2, 2019

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week: 

CMS finalizes ACO overhaul, shortening pathway for financial risk

The Centers for Medicare & Medicaid Services (CMS) finalized substantial changes to the Medicare Shared Savings Program (MSSP), an overhaul that will truncate the time that Accountable Care Organizations can remain in one-sided risk models.

FierceHealthcare

Friday, December 21, 2018

Year One Of KHN’s ‘Bill Of The Month’: A Kaleidoscope Of Financial Challenges

In 2018, KHN and NPR launched “Bill of the Month,” a crowdsourced investigation in which we dissect, investigate and explain medical bills you send us. In telling the story behind one patient’s bill each month, our goal is to understand the genesis of the often exorbitant and baffling charges that pervade the American medical system.

Kaiser Health News

Friday, December 21, 2018

Cigna closes $54 billion purchase of Express Scripts

Cigna Corp (CI.N) on Thursday closed its $54-billion deal to buy Express Scripts Holding Co, creating one of the biggest providers of pharmacy benefits and insurance plans in the United States, a combination it says will help it improve healthcare coordination and cut costs.

Reuters

Friday, December 21, 2018

Obama health law sign-ups beat forecast despite headwinds

The Affordable Care Act has yet again beaten predictions of its downfall, as government figures released Wednesday showed unexpectedly solid sign-ups for health coverage next year.

Associated Press

Thursday, December 20, 2018

Most hospitals still use mail or fax to exchange data

Health systems use numerous methods to exchange patient medical records, but providers continue to rely heavily on the old-fashioned approach of mail or fax, according to new federal data on interoperability.

FierceHealthcare

Wednesday, December 19, 2018

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week: 

Health Insurance Costs Crushing Many People Who Don’t Get Federal Subsidies

Like millions of Americans in this final week of open enrollment for the Affordable Care Act marketplaces, Diane McCabe is shopping for health insurance.

Kaiser Health News

Friday, December 14, 2018

$67B Cigna-Express Scripts merger faces one more hurdle

New York and California approved the $67 billion acquisition of Express Scripts by Cigna on Dec. 13, but New Jersey has yet to give its approval, according to a public filing.

Healthexec.com

Friday, December 14, 2018

Thursday, December 13, 2018

“Landmark” Maternal Health Legislation Clears Major Hurdle

Congress moved a big step closer on Tuesday toward addressing one of the most fundamental problems underlying the maternal mortality crisis in the United States: the shortage of reliable data about what kills American mothers.

Propublica

Thursday, December 13, 2018

Health care disruption: Thinking broadly about regulation and innovation

2018 has been a breakout year for health innovation. Major tech companies plunged fully into the health care arena, hiring teams of health care experts and launching major initiatives.

Politico

Monday, December 10, 2018

House set to vote on bill cracking down on drug companies overcharging Medicaid

The House is expected to vote next week on a bill to crack down on drug companies that overcharge the government, according to two House aides.

The Hill

Monday, December 10, 2018

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Four Questions for CoxHealth: Post-Webinar Interview

Recently, DNV GL Healthcare and CoxHealth participated in a Healthcare Web Summit webinar discussion on Unconventional Paths to Reducing Patient Readmissions. If you missed this informative webinar presentation, watch the On-Demand version here. After the webinar, we interviewed the CoxHealth team on four key takeaways from the webinar: 

1. Your study looked at readmission rates for congestive heart failure patients, how did you identify physicians with higher than average readmission rates? 

CoxHealth: We are currently identifying CHF patients who have readmitted for a second time and enrolling them in the Advanced Practice Paramedic Program.  Our data showed that if a person readmits once, they are more likely to readmit a second, third, etc time.  We felt our best use of resources was to stop the multiple readmitters. 

2. From a case management perspective, what were lessons learned from skilled nursing facilities? 

CoxHealth: We brought a few different skilled nursing facilities together and diet was determined to be the single largest item that helped keep readmission rates low.  Our APPs have a great focus on diet with the patient and the patient’s family when they enroll. 

3. Describe your Advanced Practice Paramedics program and key successes with this program in managing emergency department high utilizers. 

CoxHealth: We identify a high utilizer as anyone who visits the ED 5 or more times in a 12 month period.  One of our keys of success, that we learned because we didn’t start this way, is to have an APP in the ED to visit with the patients real-time and enroll them.  We started with a social worker doing this and we weren’t having the acceptance we were hoping for.  When we had the paramedic, who would then be coming into their home, visit about the program, our acceptance rate increased drastically.  

Another key to our success is our goal is to graduate patients from the program in approximately 90 days.  We continue to track the ED utilization after the enrollment period to ensure we don’t need to touch base again with the patient, but our goal is to work with them on what interventions can be implemented so they don’t have to visit the ED as often.  If our APPs didn’t graduate patients, we wouldn’t be able to enroll new patients and continue to grow our success. 

Our final keys to success is to not overly prescribe to the APP what they should be doing for the patient.  We have individualized care plans and encourage the APPs to think outside the box when providing care. 

4. Who pays for the APP program? 

CoxHealth: CoxHealth pays for the program.  We are proving the program’s worth through cost avoidance of low reimbursement patients in the ED as well as decreasing readmissions cost.  We are currently in discussions with two large payers to begin reimbursement for APP visits.

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

Providing Supervised Medical-Grade Heroin to Heavy Users Can Reduce Harms; Approach Merits Pilot Study in U.S. 

Providing supervised access to medical-grade heroin to people whose use continues after trying multiple traditional treatments has been successful in other countries, and should be piloted and studied in the United States, according to a new RAND Corporation study.

RAND

Thursday, December 6, 2018

A new way to curb harmful medical errors: talk more to patients and families 

A new study suggests a simple idea could go a long way toward curbing dangerous medical errors: looping in patients and families about what’s happening with their care.

Stat News

Thursday, December 6, 2018

ObamaCare enrollment down 11 percent from last year 

Enrollment in ObamaCare plans is down by 11 percent compared to last year, according to new sign up numbers released by the Trump administration.

The Hill

Thursday, December 6, 2018

Judge adds new hurdle to CVS-Aetna merger 

A federal judge could throw a wrench into the mega-merger between health giants CVS and Aetna.

The Hill

Thursday, December 6, 2018

Employers Change Tactics to Curb Health-Insurance Costs 

Company leaders are grappling with how to deal with the rising cost of health insurance in ways that get beyond the longtime strategy of simply passing on more of the burden to workers.

Wall Street Journal

Monday, December 3, 2018

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

U.S. judge raises prospect of not approving CVS-Aetna deal

In an unusual move on Thursday, a federal judge raised the prospect of not approving CVS Health Corp’s deal to buy insurer Aetna Inc, which closed earlier this week, during a routine portion of the legal process.

Reuters

Friday, November 30, 2018

Trump to Let States Divert Obamacare Funds to Other Health Plans

The Trump administration plans to allow states to direct billions of dollars of Obamacare subsidies to health plans that don’t meet the law’s requirements.

Bloomberg

Friday, November 30, 2018

HHS finalizes long-awaited 340B drug price rule

HHS on Thursday said it will allow a rule imposing ceiling prices on the 340B drug discount program to go into effect next year, after years of delays. The long-postponed rule will go into effect on Jan. 1, instead of the earlier-announced July 1, 2019 date, according to a finalized rulemaking.

Modern Healthcare

Thursday, November 29, 2018

Big Tech Expands Footprint in Health

Amazon.com Inc. is starting to sell software that mines patient medical records for information doctors and hospitals could use to improve treatment and cut costs. The move is the latest by a big technology company into health care, an industry where it sees opportunities for growth.

Wall Street Journal

Wednesday, November 28, 2018

Trump health chief 'looking closely' at thousands who lost Medicaid from work requirements

A top Trump administration health-care official on Tuesday said she is “looking closely” at why thousands of people have lost Medicaid coverage in Arkansas due to the state’s new work requirements, but indicated the administration would not slow down in implementing the new rules.

The Hill

Wednesday, November 28, 2018

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

As states race to expand Medicaid, AHIP study reaffirms the program's value

The effectiveness of Medicaid, as compared to private insurance, has long been a matter of debate, but in recent years conservative critics have not-so-quietly suggested that the program provides no improvement to beneficiaries' health whatsoever.

Fierce Healthcare

Thursday, November 15, 2018

More leeway for states to expand inpatient mental health

The Trump administration Tuesday allowed states to provide more inpatient treatment for people with serious mental illness by tapping Medicaid, a potentially far-reaching move to address issues from homelessness to violence.

AP News

Wednesday, November 14, 2018

With Hospitalization Losing Favor, Judges Order Outpatient Mental Health Treatment

When mental illness hijacks Margaret Rodgers’ mind, she acts out. Rodgers, 35, lives with depression and bipolar disorder. When left unchecked, the conditions drive the Alabama woman to excessive spending, crying and mania.

Kaiser Health News

Tuesday, November 13, 2018

Cigna app targets reduction of risks for expecting moms

Health insurer Cigna is launching a mobile app to connect members to its Healthy Pregnancies and Healthy Babies prenatal program.

Health Data Management

Tuesday, November 13, 2018

Veritas Capital, Elliott to buy Athenahealth for $5.7 billion

Private equity firm Veritas Capital and hedge fund Elliott Management are buying Athenahealth Inc (ATHN.O) for about $5.7 billion, the U.S. healthcare software maker said on Monday.

Reuters

Tuesday, November 13, 2018

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday Five: Top 5 healtcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

Health secretary warns pharma: Administration will push ahead with drug pricing reforms

Health and Human Services Secretary Alex Azar said Friday he would push ahead with drug pricing reforms despite pushback from the pharmaceutical industry.

The Hill

Friday, October 26, 2018

Trump Aims To Lower Some U.S. Drug Spending By Factoring In What Other Countries Pay

The Trump administration says it plans to change how Medicare pays for some expensive drugs for cancer and arthritis in a move to bring the costs more in line with the prices paid in European countries.

NPR

Thursday, October 25, 2018

U.S. 'turning the tide' on the opioid crisis, health secretary says

The U.S. is "beginning to turn the tide" on the opioid epidemic, HHS Secretary Alex Azar said Tuesday, pointing to new federal data showing a slight dip in overdose deaths last year.

Politico

Wednesday, October 24, 2018

CMS Broadens ACA Waiver Scope for State Insurance Programs

CMS has issued federal guidance intended to expand the scope and availability of state-level waiver programs.

HealthPayer Intelligence

Tuesday, October 23, 2018

Medicaid expansion becomes key issue in GOP-leaning states

It’s helped them win every statewide office, control the Legislature and hold all the state’s congressional seats. So it was something of a surprise for Bob Tatum when he set out to ask his fellow Nebraskans if they would back a ballot initiative to expand Medicaid, one of the pillars of Obama’s health overhaul.

Associated Press

Monday, October 22, 2018

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Three Questions for Gary Word, Ph.D., Vice President, Network and Payment Solutions, Change Healthcare: Post-Webinar Interview

Recently, Gary Word, Ph.D., Vice President, Network and Payment Solutions, Change Healthcare, participated in a Healthcare Web Summit webinar discussion on Ways to Leverage Financial Tools to Optimize Digital Member Engagement. If you missed this informative webinar presentation, watch the On-Demand version here. After the webinar, we interviewed Gary on key takeaways from the webinar:

1. How is the paradigm shifting for consumer healthcare payments?

Gary Word: Several factors are contributing to this shift. First, adoption of high-deductible health plans has increased for both sponsored plans and especially for individual health plans. This means that consumers, more than ever, bear a higher financial responsibility for their healthcare – both in terms of paying higher insurance premiums, as well as paying a larger share of their healthcare costs. Because of these factors, there is an increase in people becoming active consumers and shoppers. In this way, healthcare payers and providers have entered an era of consumerism. Payers and providers need to attract and retain consumers, partly by providing tools that facilitate a smooth healthcare payment experience. In the digital consumer era, this means that payers that offer digital tools are more likely to retain a member.  Providers are also expected to improve the consumer user experience to ease the historically complex exercise of understanding healthcare finances.

2. How is the change in consumer payment responsibility having an impact on provider financials?

Gary Word: With the increase in high-deductible health plans, consumers are responsible for a much larger portion of healthcare expenses. The collection of these obligations is of increasing importance for providers. The billing process has also become more complex, with a single hospital visit sometimes resulting in the consumer receiving many bills, some from providers they didn’t even know provided them with healthcare services. We know there is a direct correlation between satisfaction in the billing process and whether or not the consumer will pay his or her bill in full and in a timely manner, or even return to the provider for future service. Conversely, a consumer that is satisfied with their healthcare billing experience is more likely pay their obligation in full and more likely to return to the provider.

3. Tell us more about how the Change Healthcare solution is supporting Aetna’s mission to improve member engagement and experience?

Gary Word: The payer is in a unique position to facilitate payment across all providers a member sees from a centralized location. Our consumer surveys indicate that payers are typically a trusted resource to verify financial obligations because the information the payer includes in the explanation of benefits is what the consumer trusts to be the correct patient responsibility. By offering a centralized payment option for the consumer, a payer enhances relations and satisfaction with both providers and consumers by facilitating collections and payments, while also earning additional opportunities to engage with their membership. It’s a win-win-win situation. 

Aetna has partnered with Change Healthcare to enable processed claims to effectively serve as a patient statement proxy and allow the member to easily pay their providers for their patient responsibility within the Aetna member application. Upon reviewing the claim detail and seeing the patient responsibility, the consumer is offered the ability to make a payment right then and there. Aetna and Change Healthcare then work together to process the payment and send the funds to the provider. The ease of payments increases the likelihood that the member will turn again to Aetna to make future payments.  Aetna will then be able to engage with the member and provide targeted messages – such as for wellness initiatives or broader communications. Additionally, these digital tools are easing the member’s burden and stress associated with healthcare financial management by providing insights into expenditures to aid consumers with planning and management of costs, allowing Aetna to focus on the total healthcare of their membership. 

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

Health Care Tops Guns, Economy As Voters’ Top Issue

Health care has emerged as the top issue for voters headed into the midterm elections, but fewer than half of them say they are hearing a lot from candidates on the issue, according to a new poll released Thursday.

Kaiser Health News

Thursday, October 18, 2018

Trump: All Republicans will support people with pre-existing conditions 'after I speak to them'

President Trump tweeted Thursday that “all Republicans support people with pre-existing conditions, and if they don’t, they will after I speak to them.”

The Hill

Thursday, October 18, 2018

What will CVS-Aetna mega-merger mean for consumer choice

It's the latest merger between two major healthcare players that could affect tens of millions of Americans. Last week, CVS and insurance giant Aetna finalized a nearly $70 billion merger. The deal could impact where people get their care, how they get their drugs and how much choice they have. Judy Woodruff discusses with Larry Merlo, CEO of CVS Health.

PBS News

Tuesday, October 16, 2018

Insurer Anthem will pay record $16M for massive data breach

The nation’s second-largest health insurer has agreed to pay the government a record $16 million to settle potential privacy violations in the biggest known health care hack in U.S. history, officials said Monday.

AP News

Tuesday, October 16, 2018

Medicare Advantage Riding High As New Insurers Flock To Sell To Seniors

Health care experts widely expected the Affordable Care Act to hobble Medicare Advantage, the government-funded private health plans that millions of seniors have chosen as an alternative to original Medicare.

KFF

Monday, October 15, 2018

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday Fve: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

Premiums for popular ACA health insurance dip for the first time

The average price tag for the most popular level of insurance sold in the Affordable Care Act’s federal marketplaces is dropping slightly, the first time the rates have stopped going up since the health plans were created a half-dozen years ago.

Washington Post

Friday, October 12, 2018

Prescriptions for Millions of Opioid Pills Lead to Charges Against 5 Doctors

It was not hard to tell when the doctor was in at the Staten Island office of Carl Anderson. Noisy crowds of people, some with visible signs of drug addiction, stood in long lines at all hours of the night, seeking prescriptions for oxycodone pills, the authorities said Thursday.

The New York Times

Thursday, October 11, 2018

CVS Health and Aetna $69 Billion Merger Is Approved With Conditions

The Justice Department’s approval of the $69 billion merger between CVS Health and Aetna on Wednesday caps a wave of consolidation among giant health care players that could leave American consumers with less control over their medical care and prescription drugs.

The New York Times

Wednesday, October 10, 2018

Trapped by the ‘Walmart of Heroin’

The first time Mark shot up “Philly dope” was in the summer of 2017, with his girlfriend, Sarah. They had been on their way from Massachusetts to South Carolina, hoping to get clean there and find someplace cheap to live. The plan was to detox slowly on the way. In New Jersey, they needed to buy more drugs, just enough to make it to Myrtle Beach.

The New York Times

Wednesday, October 10, 2018

Cross-market hospital mergers continue despite rising regulatory scrutiny

The proposed tie-up between Dallas-based Baylor Scott & White Health and Houston-based Memorial Hermann Health System poses an increasingly important antitrust question given the prevalence of cross-market hospital mergers, regulatory experts said.

Modern healthcare

Monday, October 8, 2018

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

Congress OKs opioid legislation in show of bipartisanship

Setting aside the Supreme Court fight, members of Congress this week approved bipartisan legislation aimed at curbing the devastating opioid addiction across the country.

The Associated Press

Thursday, October 4, 2018

GOP senators scrutinize CBO's new health insurance simulation model

Republicans on the Senate Budget Committee have pressed the Congressional Budget Office to release details of the forthcoming new health insurance simulation model.

Modern Healthcare

Thursday, October 4, 2018

Premiums see moderate increase in 2018 for employer plans

Premiums for individuals and families enrolled in employer plans increased moderately in 2018, but more workers are paying higher deductibles, according to a new survey released Wednesday.

The Hill

Wednesday, October 3, 2018

Despite Patient Privacy Risks, More People Use Wearables for Health

Despite the patient privacy risks that collecting health data on insecure wearable devices could pose, the number of US consumers tracking their health data with wearables has more than doubled since 2013, according to the Deloitte 2018 Survey of US Health Care Consumers.

Health IT Security

Wednesday, October 3, 2018

Pfizer CEO to step down at end of year

Pfizer CEO Ian Read will step down at the end of the year after eight years of leading the pharmaceutical giant. Albert Bourla, Pfizer's current chief operating officer, will succeed Read on Jan. 1.

The Hill

Monday, October 1, 2018

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

Trump health chief: Premiums to drop for popular ACA plan

Premiums for a popular type of “silver” health plan under the Affordable Care Act will edge downward next year in most states, the Trump administration’s health chief announced Thursday.

AP News

Friday, September 28, 2018

Aetna sells Medicare drug business, clearing way for $69 billion CVS merger

Health insurer Aetna Inc. said Thursday that it plans to sell its Medicare prescription drug plan business to WellCare Health Plans Inc., according to a filing with the Securities and Exchange Commission (SEC).

The Hill

Thursday, September 27, 2018

Trump administration defends Medicaid work requirements

A top health official in the Trump administration defended Medicaid work requirements Thursday, arguing that its intent isn't to expel people from the program.

The Hill

Thursday, September 27, 2018

31% of Beneficiaries Face Social Isolation, More Health Risks

A new survey of Humana’s commercial population has found that almost one-third of members over 65 years old experience social isolation. The survey reveals that payers could benefit by addressing social isolation among their elderly members because reducing loneliness enhances member satisfaction as well as overall health.

HealthPayer Intelligence

Tuesday, September 25, 2018

Major healthcare groups question Medicare ACO proposal

MSSP has been under a spotlight lately with the proposed changes. Reports have shown savings, but not necessarily as much as initially expected. The regulatory push toward more risk reflects a desire for providers to commit to value-based contracting despite the potential for financial loss.

Healthcare Dive

Monday, September 24, 2018

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

As States Try To Rein In Drug Spending, Feds Slap Down One Bold Medicaid Move

States serve as “laboratories of democracy,” as U.S. Supreme Court Justice Louis Brandeis famously said. And states are also labs for health policy, launching all kinds of experiments lately to temper spending on pharmaceuticals.

Kaiser Health News

Friday, September 21, 2018

Despite Red Flags At Surgery Centers, Overseers Award Gold Seals

At his surgery center near San Diego, Rodney Davis wore scrubs, was referred to as “Dr. Rod” and carried the title of director of surgery. But he was a physician assistant, not a doctor, who anesthetized patients and performed liposuction with little input from his supervising doctor, court records show.

Kaiser Health News

Thursday, September 20, 2018

Time Helps Accountable Care Organizations Realize Savings in MSSP

Experience is a key factor to realizing greater cost savings in the Medicare Shared Savings Program (MSSP), a new Avalere analysis found.

RevCycle Intelligence

Thursday, September 20, 2018

Does investing in pop health and social determinants work? New study finds link to lower Medicare spending

Proponents and skeptics not convinced that investing in population-level interventions and social determinants of health, take note: New research finds that the overall well-being of a population on a county level is associated with lower healthcare spending for each Medicare fee-for-service beneficiary.

Healthcare Finance News

Wednesday, September 19, 2018

Cigna deal gets antitrust nod, positive sign for CVS/Aetna

Health insurer Cigna Corp’s (CI.N) $52 billion acquisition of pharmacy benefits manager Express Scripts Holding Co has passed U.S. antitrust scrutiny, the companies said on Monday, allowing them to proceed with a combination they say will lead to lower costs by better coordinating pharmacy and medical benefits.

Reuters

Tuesday, September 18, 2018

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

By Claire Thayer, September 14, 2018

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

New Medicare Advantage Tool To Control Drug Prices Could Narrow Choices

Starting next year, Medicare Advantage plans will be able to add restrictions on expensive, injectable drugs administered by doctors to treat cancer, rheumatoid arthritis, macular degeneration and other serious diseases.

NPR

Friday, September 14, 2018

Here’s the data behind the new Apple Watch EKG app

When the new Apple Watch heart monitoring app can get a reading, it can accurately detect that a person has an irregular heart rhythm known as atrial fibrillation 99 percent of the time, according to a study of the new device that Apple submitted to the Food and Drug Administration.

Stat News

Friday, September 14, 2018

Calling teen vaping 'epidemic,' officials weigh flavor ban

U.S. health officials are sounding the alarm about teenage use of e-cigarettes, calling the problem an "epidemic" and ordering manufacturers to reverse the trend or risk having their flavored vaping products pulled from the market.

ABC News

Thursday, September 13, 2018

Hospital Operating Margins Slide 39% After ACA Expansion

The three-year stretch between 2015 to 2017 saw widespread income deterioration along with declining operating margins, according to a new study.

HealthLeaders

Wednesday, September 12, 2018

ACA about-face: Insurers keeping premium increases lower than last year, RWJF and AP studies find

The Affordable Care Act market has turned around for 2019, according to two studies, and that means premiums are not increasing as much as they did in 2018.

Healthcare Finance News

Tuesday, September 11, 2018

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Provider Directories – What’s Next for Provider Data Exchange?

By Claire Thayer, September 5, 2018

The U.S. spends a staggering $2.1B annually across the healthcare industry chasing and maintaining provider data – and as much as 75% of this cost is duplicative. Maintaining and facilitating exchange of accurate provider data is a critical component to payers being able to operate effectively and ensure their members have access to the care they need. But a key challenge remains: inaccurate provider data.

This recent edition of the MCOL infoGraphoid, co-sponsored by LexisNexis Risk Solutions, features key concepts impacting the provider information paradigm and core elements essential for provider data exchange.

MCOL’s weekly infoGraphoid is a benefit for MCOL Basic members and released each Wednesday as part of the MCOL Daily Factoid e-newsletter distribution service – find out more here.

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

By Claire Thayer, August 31, 2018

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

How Modern Medicine Has Changed the Supreme Court

Two related health trends mean that each Supreme Court nomination now has the potential to shape the nation’s highest court for far longer than in the past.

The New York Times

Friday, August 31, 2018

The $109K Heart Attack Bill Is Down To $332. What About Other Surprise Bills?

A Texas hospital that charged a teacher $108,951 for care after a heart attack slashed the bill to $332.29 Thursday — but not before the huge charge sparked a national conversation over what should be done to combat surprise medical bills that afflict a growing number of Americans.

Kaiser Health News

Friday, August 31, 2018

Trade deal between U.S. and Mexico is criticized for allowing high drug prices to continue

Although details of the new trade deal between the U.S. and Mexico have not yet been released, a fight is already brewing among some drug makers and consumer advocates over one provision.

Stat News

Thursday, August 30, 2018

CFOs Expect Higher Hospital Labor Costs As Staffing Shortages Loom

About 78 percent of healthcare finance leaders expect hospital labor costs to grow in the next 12 months as the industry faces a worsening shortage of healthcare professionals, a new survey shows.

RevCycle Intelligence

Wednesday, August 29, 2018

Healthcare Ridesharing Makes Inroads in Lost Revenue

Nearly 4 million patients per year miss out on care due to lack of available transportation options related to cost or geographic barriers, according to the 2017 American Hospital Association study, "Transportation and the Role of Hospitals."

Health Leaders Media

Monday, August 27, 2018

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

By Claire Thayer,  August 24, 2018

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

CIGNA Shareholders Approve $52B Express Scripts Merger

Cigna shareholders overwhelmingly approved the merger agreement with Express Scripts on Friday morning, the health insurer announced. Early results show that 90% of shareholders favored the proposal.

HealthLeaders

Friday, August 24, 2018

Your Office Doctor Is Getting a Big Push From Private Investors

A group of investors is putting up $165 million to fuel an expansion of Paladina Health, bringing a recent surge of private funds flowing into companies that run primary-care clinics to more than a half-billion dollars.

Bloomberg

Thursday, August 23, 2018

Senate backs $854B bill to fund health, education, military

The Senate approved an $854 billion measure Thursday that funds much of the government, including $675 billion for the Defense Department. The bill combines military spending with disbursements for Health and Human Services, Education, Labor and other agencies.

The Associated Press

Thursday, August 23, 2018

The Man Who Used To Run Medicaid Has A New Idea To Make It Better

Andy Slavitt was working as an executive at Optum in 2013 when he was called in to be part of the team tasked with repairing Healthcare.gov’s disastrous rollout, kicking off a two-year stint as acting administrator of the Centers for Medicare and Medicaid Services.

Forbes

Thursday, August 23, 2018

Why Are Black And Latino Kids More Likely To Die Of Certain Cancers?

When it comes to cancer survival, the United States is sharply divided by race. According to the Centers for Disease Control and Prevention, the cancer death rate for African-Americans is 25 percent higher than whites, and Hispanics and Latinos are more likely to be diagnosed with cancer at a late, and more dangerous, stage of the disease.

NPR

Tuesday, August 21, 2018

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

Purdue Pharma’s Sales Pitch Downplayed Risks Of Opioid Addiction

Two decades ago, Purdue Pharma produced thousands of brochures and videos that urged patients with chronic pain to ask their physicians for opioids such as OxyContin, arguing that concerns over addiction and other dangers from the drugs were overblown, company records reveal.

Kaiser Health News

Friday, August 17, 2018

Best Buy to buy a provider of health devices for the aging

Consumer electronics retailer Best Buy is pushing more into the health field, acquiring a company that provides emergency response devices for the aging.

ABC News

Thursday, August 16, 2018

Google parent invests $375M in ObamaCare startup Oscar

Google’s parent company, Alphabet, is investing $375 million in Oscar Health, a startup health insurance company seeking to redefine the industry by using technology and data.

The Hill

Wednesday, August 15, 2018

Icahn Drops Fight to Block Cigna's Express Scripts Takeover

Activist investor Carl Icahn has dropped his fight to block Cigna Corp.’s $54 billion acquisition of Express Scripts Holding Co. after two prominent shareholder advisory firms came out in support of the deal.

Bloomberg

Tuesday, August 14, 2018

Employers drive healthcare change through direct contracting, ACOs, combatting opioid epidemic

With the cost of ensuring employees sharply on the rise, employers are innovating now and planning for the future because they are frustrated with the pace at which the industry itself is driving change.

Healthcare Finance News

Monday, August 13, 2018

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.