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 to Issue Stop-Payment Order on Health Care Subsidies In a brash move likely to roil insurance markets, President Donald Trump will "immediately" halt payments to insurers under the Obama-era health care law he has been trying to unravel for months. The Associated Press Friday, October 13, 2017 Trump’s Order Advances GOP Go-To Ideas To Broaden Insurance Choices, Curb Costs The Trump administration Thursday advanced a wide-ranging executive order aimed at expanding lower-cost insurance options, allowing employers to give workers money to buy their own coverage and slowing consolidation in the insurance and hospital industries. Kaiser Health News Thursday, October 12, 2017 House Republicans Ramp Up Scrutiny of Providers in Drug Discount Program House Republicans are intensifying scrutiny of a federal program that gives thousands of safety-net providers hefty discounts on prescription drugs but that they say doesn’t have effective tools to track where the savings are going. Morning Consult Wednesday, October 11, 2017 Long-Term Disability Insurance Gets Little Attention But Can Pay Off Big Time “It won’t happen to me.” Maybe that sentiment explains consumers’ attitude toward long-term disability insurance, which pays a portion of your income if you are unable to work. Sixty-five percent of respondents surveyed this year by LIMRA, an association of financial services and insurance companies, said that most people need disability insurance. Kaiser Health News Tuesday, October 10, 2017 Overlooked By ACA: Many People Paying Full Price For Insurance ‘Getting Slammed’ Paul Melquist of St. Paul, Minn., has a message for the people who wrote the Affordable Care Act: “Quit wrecking my health care.” Teri Goodrich, of Raleigh, N.C., has the same complaint. “We’re getting slammed. We didn’t budget for this,” she said. Kaiser Health News Monday, October 9, 2017 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 Guts Requirement That Employer Health Plans Pay For Birth Control The Trump administration is rolling back the Obama-era requirement that employer-provided health insurance policies cover birth control methods at no cost to women. NPR Friday, October 6, 2017 Association Health Plans: A Favorite GOP Approach To Coverage Poised For Comeback Not even 24 hours after the latest “repeal and replace” proposal ran out of steam, Sen. Rand Paul (R-Ky.) ignited a new round of health policy speculation by predicting, during a cable news interview, impending Trump administration action on a longtime Republican go-to idea: association health plans. Kaiser Health News Friday, October 6, 2017 House passes GOP budget in key step for upcoming tax debate The House on Thursday passed a $4.1 trillion budget plan that promises deep cuts to social programs while paving the way for Republicans to rewrite the tax code later this year. The 2018 House GOP budget reprises a controversial plan to turn Medicare into a voucher-like program for future retirees as well as the party’s efforts to repeal the “Obamacare” health law. The Washington Post Thursday, October 5, 2017 Bill to Rescue Children’s Health Program Hits Snag in House Legislation to rescue the Children’s Health Insurance Program sailed through a Senate committee on Wednesday, but touched off a partisan conflict in the House, diminishing hopes that the popular program would be quickly refinanced. The New York Times Wednesday, October 4, 2017 Cigna says it won’t cover OxyContin prescriptions through employer plans The health insurer Cigna on Wednesday announced it will no longer cover OxyContin prescriptions for customers on its employer-based health plans, the second major announcement in two weeks from an industry group billed as an effort to slow the opioid epidemic. Stat News Wednesday, October 4, 2017 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 29, 2017

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 adds open enrollment period, offers regulatory relief for payers and members in wake of hurricanes

CMS has announced special open enrollment periods for all Medicare enrollees and some federal health insurance exchange consumers in the wake of hurricanes Harvey, Irma and Maria, along with other disaster-related policies to help insurance companies in affected areas.

FierceHealthcare. Friday, September 29, 2017

Senators close to bipartisan deal on health exchanges: Schumer

Two U.S. senators from both parties are close to finalizing a bipartisan deal to shore up the health insurance exchanges created under Obamacare, the chamber’s top Democrat said on Thursday.

Reuters. Thursday, September 28, 2017

Price took military jets to Europe, Asia for over $500K

The White House approved the use of military aircraft for multi-national trips by Health and Human Services Secretary Tom Price to Africa and Europe this spring, and to Asia in the summer, at a cost of more than $500,000 to taxpayers.

Politico. Thursday, September 28, 2017

Health crisis in Puerto Rico: Few hospitals have power or fuel, but public health officials fear the worst is yet to come

Only 11 of Puerto Rico’s 69 hospitals have power or fuel, leaving the few hospitals that are open to handle a surge of injured patients and those who need care for chronic conditions.

Fierce Healthcare. Wednesday, September 27, 2017

Anthem Says No To Many Scans Done By Hospital-Owned Clinics

Tightening the screws on pricey imaging exams, health insurer Anthem will no longer allow many patients to get MRI or CT scans at hospital-owned outpatient facilities, requiring them to use independent imaging centers instead. NPR Wednesday, September 27, 2017

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 Data Accuracy – Continued Challenges for Health Plans

By Claire Thayer, September 27, 2017

Inaccurate provider directories continue to pose challenges for health plans both in terms of removing barriers to patient care as well as the monumental task of keeping track of network providers and managing all data elements associated with a single provider record.  Not only is the data constantly changing, consider this: documenting this information takes time as a detailed record can track up to 380 distinct line items, including service locations, billing locations, payment locations, specialties, certifications, affiliations, office hours, and languages spoken.  Regulations have been enacted on both the federal and state level on required data elements and timeliness of maintenance requirements, with penalties for non-compliance and regulations that vary widely from state-to-state.

This weeks’ edition of the MCOL Infographic, co-sponsored by LexisNexis, focuses on increasing challenges for health plans with data reporting and maintenance of provider directories:

 

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

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: Of Cassidy-Graham’s four co-sponsors, only one has the support of his governor The latest Republican health-care bill gives significant power to the states. But several of the nation’s governors, including a handful of Republicans, aren't interested. The Washington Post Friday, September 22, 2017 CVS tightens restrictions on opioid prescriptions in bid to stanch epidemic CVS Health announced Thursday that it was limiting the amount and strength of prescription opioid painkillers it provides to patients taking the drugs for the first time, a step intended to help curb opioid abuse. Stat News Thursday, September 21, 2017 Graham-Cassidy Health Bill Would Shift Funds from States That Expanded Medicaid Senate Republicans' latest plan to overhaul the U.S. health care system ends with a massive shift of federal money from states that expanded Medicaid — and are largely dominated by Democrats — to those that refused to expand. NPR Thursday, September 21, 2017 Almost half of Americans favor single-payer healthcare system, poll finds Congressional Republicans may be trying once again to repeal and replace the Affordable Care Act with a more market-based approach, but a new poll finds that almost half of Americans favor a plan more in line with the single-payer offering served up earlier this year by progressive Sen. Bernie Sanders. Healthcare Finance News Wednesday, September 20, 2017 Amazon in talks with PBMs over pharma supply chain Amazon is reportedly communicating with pharmacy benefit managers about potential drug contracts, according to a Leerink Partners analysis cited by CNBC. Amazon has been hiring more healthcare leaders and expanding its drug and medical supply distribution in recent months, spurring rumors the online retailer is stepping into the pharmacy business. Becker's Hospital Review Wednesday, September 20, 2017 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:

Centrist Democrats Turn to Pragmatism, Seek Bipartisan ACA Fixes

While some progressives campaigned this week for “Medicare for all,” a group of moderate House Democrats aligned themselves with a more modest push to stabilize the Affordable Care Act, arguing that it could spur broader health care reforms in the future.

Morning Consult

Friday, September 15, 2017

CBO: ObamaCare uncertainty will lead to 15 percent hike in premiums

Premiums for ObamaCare's benchmark silver plans will increase by an average of 15 percent in 2018, the Congressional Budget Office (CBO) estimated in a new report released Thursday.

The Hill

Thursday, September 14, 2017

Sanders Offers Medicare-for-All Plan Backed by 16 Senate Democrats

Sixteen Senate Democrats are flirting with a single-payer health-care system, marking a shift within the party on what was once viewed as a politically treacherous issue that attracted little support from lawmakers.

Bloomberg

Wednesday, September 13, 2017

Stanford study: Three-quarters of opioid prescriptions written for 10 percent of patients

A new Stanford University study reveals a startling fact about the nation’s opioid crisis: A small minority of Americans account for the large majority of drug abusers.

Mercury News

Tuesday, September 12, 2017

Uninsured Rate Falls to Record Low Of 8.8%

Three years after the Affordable Care Act’s coverage expansion took effect, the number of Americans without health insurance fell to 28.1 million in 2016, down from 29 million in 2015, according to a federal report released Tuesday.

Kaiser Health News

Tuesday, September 12, 2017

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 Administration Sharply Cuts Spending on Health Law Enrollment The Trump administration is slashing spending on advertising and promotion for enrollment under the Affordable Care Act, a move some critics charged was a blatant attempt to sabotage the law. New York Times Thursday, August 31, 2017 5 Outside-The-Box Ideas For Fixing The Individual Insurance Market With Republican efforts to “repeal and replace” the Affordable Care Act stalled, tentative bipartisan initiatives are in the works to shore up the fragile individual insurance market that serves roughly 17 million Americans. Kaiser Health News Wednesday, August 30, 2017 Pioneering Cancer Gene Therapy Gets Green Light — And $475,000 Price Tag The country’s first approved gene therapy — approved Wednesday to fight leukemia that resists standard therapies — will cost $475,000 for a one-time treatment, its manufacturer announced. Kaiser Health News Wednesday, August 30, 2017 Advisory Board to sell healthcare, education units in $2.58 billion deal Advisory Board Co said it would sell its healthcare business to UnitedHealth Group Inc’s Optum unit and education business to private equity firm Vista Equity Partners, for a total deal value of $2.58 billion. Reuters Tuesday, August 29, 2017 Majority of Voters Support Medicaid Work Requirements A majority of voters back the idea of tying Medicaid eligibility to employment status as the Trump administration weighs whether to give more states the power to impose work requirements on the government health program. Morning Consult Monday, August 28, 2017 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.

Are you ready to meet the challenge of managing member identities?

By Claire Thayer, August 31, 2017

Healthcare consumers believe that their providers and health plans are taking measures to protect their digital healthcare data, yet a recent Accenture survey on Healthcare Cybersecurity and Digital Trust finds that one of four health care consumers (26%) has experienced a breach of their digital healthcare data, which may include their Social Security number, contact information, electronic medical record or health  insurance ID. And, of these, half were victims of medical identity theft.  Following a breach one-quarter (25%) of those experiencing a breach changed their healthcare providers, 21 percent changed their health insurance company, and 34% lost trust in the organization.

This weeks’ edition of the MCOL Infographic, co-sponsored by LexisNexis, highlights some of the issues and challenges involved in actively managing member identities and impact of security breaches: 

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

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: Time Crunch Among Hurdles for Bipartisan Senate Push to Bolster ACA The leaders of a key Senate committee say they are cautiously optimistic about reaching a deal to shore up the Affordable Care Act’s individual marketplaces, but even with a bipartisan effort, it is far from certain whether they can hash out an agreement in time. Morning Consult Friday, August 18, 2017 EpiPen maker to settle on claims it overcharged taxpayers, agrees to have pricing practices reviewed Mylan will pay $465 million to settle claims that it overcharged states for its signature EpiPen, according to a Thursday Department of Justice press release. The company also signed an agreement with the federal government to enter into a review of its pricing practices. Stat News Thursday, August 17, 2017 Express Scripts to limit opioids, concerning doctors The nation’s largest pharmacy benefit manager will soon limit the number and strength of opioid drugs prescribed to first-time users as part of a wide-ranging effort to curb an epidemic affecting millions of Americans. Stat News Wednesday, August 16, 2017 Federal deficit will soar to $194 billion, premiums spike 20% if Trump nixes cost-sharing subsidies, CBO report says The federal deficit will soar by $194 billion over the next nine years and gross premiums for silver plans, the most popular, would spike 20 percent higher in 2018 and 25 percent higher by 2020 if President Trump follows through a proposal to eliminate the cost-sharing subsidies that allow low-income consumers to purchase and afford health plans on the individual ACA insurance exchanges, a report from the Congressional Budget Office said. Healthcare Finance News Tuesday, August 15, 2017 CMS cancels two mandatory pay models and scales back a third The CMS on Tuesday said it will toss two bundled payment models and cut down the number of providers required to participate in a third, citing providers' requests to have more input in the models' designs. Modern Healthcare Tuesday, August 15, 2017 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 Plans to Declare Opioid Epidemic a National Emergency President Trump said on Thursday that he was preparing to officially declare the United States’ worsening epidemic of opioid overdoses as a national emergency, accepting an urgent recommendation from a national commission that he appointed. The New York Times Thursday, August 10, 2017 Early 2018 marketplace rates vary widely across states Health insurers selling individual plans next year on the federally operated marketplace, HealthCare.gov, have until Wednesday to finalize their rates. But early filings provide a good look at how the ACA marketplace is shaping up for 2018. Modern Healthcare Thursday, August 10, 2017 Bipartisan health policy coalition urges Congress to strengthen the ACA An unlikely coalition of liberal and conservative health-policy leaders is calling on Congress to strengthen the existing health-care law in a variety of ways to help Americans get and keep insurance. The Washington Post Wednesday, August 9, 2017 Taking A U-Turn On Benefits, Big Employers Vow To Continue Offering Health Insurance The shrinking unemployment rate has been a healthy turn for people with job-based benefits. Eager to attract help in a tight labor market and unsure of Obamacare’s future, large employers are newly committed to maintaining coverage for workers and often their families, according to new research and interviews with analysts. Kaiser Health News Tuesday, August 8, 2017 Large employers increasingly leaning on value-based contracts Instead of looking to reduce demand by shifting costs to employees, large employers are increasingly hoping to constrain health insurance cost growth through value-based contracts with providers, according to a survey released Tuesday by the National Business Group on Health. Modern Healthcare Tuesday, August 8, 2017 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: Millions More Uninsured Could Impact Health Of Those With Insurance, Too Much has been written lately about how individuals’ health could suffer if they lose insurance under the health proposals circulating in the U.S. House and Senate. But there is another consequence: creating millions more people without insurance could also adversely affect the health of people who remain insured. Kaiser Health News. Friday, July 14, 2017 Senate Republicans Unveil New Health Bill, but Divisions Remain Senate Republican leaders on Thursday unveiled a fresh proposal to repeal and replace the Affordable Care Act, revising their bill to help hold down insurance costs for consumers while allowing insurers to sell new low-cost, stripped down policies. The New York Times Friday, July 14, 2017 U.S. Charges 412, Including Doctors, in $1.3 Billion Health Fraud Hundreds of people nationwide, including dozens of doctors, have been charged in health care fraud prosecutions, accused of collectively defrauding the government of $1.3 billion, the Justice Department said on Thursday. The New York Times Thursday, July 13, 2017 Nursing Homes Move Into The Insurance Business Around the country, a handful of nursing home companies have begun selling their own private Medicare insurance policies, pledging close coordination and promising to give clinicians more authority to decide what treatments they will cover for each patient. Kaiser Health News. Thursday, July 13, 2017 Fewer exchange plans available in 2018, CMS says The Centers for Medicare and Medicaid Services has released what it calls further proof the Affordable Care Act is failing in data showing a 38 percent decrease in the number of health plans available in the individual market for the upcoming open enrollment period compared to this year. Healthcare Finance News. Monday, July 10, 2017 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, July 7, 2017

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:

GOP leader says he'll rework health bill, but offers Plan B

Senate Majority Leader Mitch McConnell says he plans to produce a fresh bill in about a week scuttling and replacing much of President Barack Obama's health care law. But he's also acknowledging a Plan B if that effort continues to flounder.

AP News

Friday, July 7, 2017

States Move To Tighten Medicaid Enrollment, Even Without A New Health Law

No corner of the health care system would be harder hit than Medicaid, the federal-state health insurance program for the poor, if Republican leaders in Congress round up the votes to repeal major portions of the Affordable Care Act.

NPR News

Thursday, July 6, 2017

CMS won't delay controversial managed care requirements

The CMS is moving forward with controversial provisions from the mega managed-care rule that expands federal oversight over Medicaid programs after refusing several states' requests to delay implementation.

Modern Healthcare

Thursday, July 6, 2017

Should GOP Health Bill Prevail, Say Bye-Bye To Insurance Rebates

If Senate GOP leaders have their way, the check may not be in the mail. Many consumers collected unexpected rebates after the Affordable Care Act became law, possibly with a note explaining why: Their insurer spent more of their revenue from premiums on administration and profits than the law allowed, so it was payback time.

Kaiser Health News

Wednesday, July 5, 2017

What Tax Breaks? Those Promised In GOP Plans Go Mostly To Top 1%

There’s much talk on Capitol Hill about the tax cuts included in the Republican health plans, but unless you are a frequent user of tanning beds or have personal wealth that puts you in the top 1 percent, you might not feel much effect from them.

Kaiser Health News

Wednesday, July 5, 2017

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 further disrupts Obamacare repeal efforts

Just three days after running a widely praised meeting among GOP senators devoted to repealing Obamacare, President Donald Trump threw Senate Majority Leader Mitch McConnell's already ailing bill into further chaos Friday.

Politico. Friday, June 30, 2017

Men Wrote The Senate Health Care Bill. This Woman Could Stop It.

As Majority Leader Mitch McConnell (R-Ky.) tries to negotiate his way to a health bill that can win at least 50 Republican votes, there is one woman in the Senate who could stop the bill cold. She isn’t even a senator. Elizabeth MacDonough is the Senate’s parliamentarian, the first woman to hold that post, which involves advising senators on the chamber’s byzantine rules and procedures.

Kaiser Health News. Friday, June 30, 2017

Just 17 Percent Of Americans Approve Of Republican Senate Health Care Bill

Americans broadly disapprove of the Senate GOP's health care bill, and they're unhappy with how Republicans are handling the efforts to repeal and replace the Affordable Care Act, according to a new NPR/PBS NewsHour/Marist poll.

NPR. Wednesday, June 28, 2017

From Birth To Death, Medicaid Affects The Lives Of Millions

Medicaid is the government health care program for the poor. That's the shorthand explanation. But Medicaid is so much more than that — which is why it has become the focal point of the battle in Washington to repeal and replace the Affordable Care Act, also known as Obamacare. NPR. Tuesday, June 27, 2017

Tuesday, June 27, 2017

Senate And House Take Different Plans To Scrap Individual Mandate

The Affordable Care Act’s tax penalty for people who opt out of health insurance is one of the most loathed parts of the law, so it is no surprise that Republicans are keen to abolish it. But the penalty, called the individual mandate, plays a vital function: nudging healthy people into the insurance markets where their premiums help pay for the cost of care for the sick. Kaiser Health News. Monday, June 26, 2017

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. 

Top Challenges Facing Healthcare Executives

By Claire Thayer, June 29, 2017

Complying with government requirements and mandates continues to be one of the top challenges healthcare executives face along with health insurance affordability. Healthcare providers rank quality and patient safety outcomes, electronic health records,  privacy and cybersecurity as top priorities for their organizations.

This weeks’ edition of the MCOL Infographic, co-sponsored by LexisNexis, offers highlights of these and other pressing concerns for healthcare executives today:

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

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:

The Health 202: McConnell will be a legislative wizard if health care passes

Senate Republicans have finally revealed their plan to revamp the Affordable Care Act. Now, they're just trying to pass it. There will be lots of twists and turns along the path to an anticipated vote next week -- and it's by no means assured the GOP will get there.

The Washington Post

Friday, June 23, 2017

Senate Health Care Bill Includes Deep Cuts to Medicaid

Senate Republicans, who for seven years have promised a repeal of the Affordable Care Act, took a major step on Thursday toward that goal, unveiling a bill to make deep cuts in Medicaid and end the law’s mandate that most Americans have health insurance.

New York Times

Thursday, June 22, 2017

Who Wins, Who Loses With Senate Health Care Bill

Republicans in the Senate on Thursday unveiled their plan to repeal and replace the Affordable Care Act — also known as Obamacare. The long-awaited plan marks a big step towards achieving one of the Republican party's major goals.

NPR

Thursday, June 22, 2017

Despite A Growing Appetite, Buffet-Style Flat-Fee Clinics Shutter In Seattle

In recent years, a small but growing number of practices embraced a buffet approach to primary care, offering patients unlimited services for a modest flat fee instead of billing them a la carte for every office visit and test. But after a pioneering practice shut its doors earlier this month, some question whether “direct primary care,” as it’s called, can succeed.

Kaiser Health News

Tuesday, June 20, 2017

GOP, Dem governors call for changes in House health bill

A group of Republican and Democratic governors are echoing President Donald Trump’s criticism of a House GOP health care bill, saying it threatens coverage for the most vulnerable. Instead, they’re asking Senate leaders to work together on an overhaul of Democrat Barack Obama’s health care law.

Associated Press

Friday, June 16, 2017
 

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:

Senate likely to miss its Obamacare repeal deadline

Politico reports: Senate Republicans are getting dangerously close to missing their deadline to hold a Senate health care vote by month’s end, potentially derailing fulfillment of their 7-year-old campaign promise to repeal Obamacare. Friday, June 16, 2017

Cleveland Clinic jumps into insurance biz with Oscar Health

Modern Healthcare reports: While many health insurers are fleeing the individual market, health system Cleveland Clinic is jumping into the insurance business head first with the New York-based startup Oscar Health. Thursday, June 15, 2017

Price Clashes With Senators Over Path to Combat Opioid Crisis

Morning Consult reports: Health and Human Services Secretary Tom Price says combating the opioid crisis is one of his top priorities, a goal that has bipartisan support on Capitol Hill.

Thursday, June 15, 2017

Descent Into Secrecy: Senate Health Talks Speak To Steady Retreat From Transparency

Kaiser Health News reports: Congress struggling to finish a huge budget reconciliation bill. A GOP president pushing a major overhaul of federal payments for health insurance that could transform the lives of sick patients. Wednesday, June 14, 2017

With or without Washington, states are already remaking Medicaid

Politico reports: Medicaid is now the biggest health program in the country, covering more than 70 million people, or 1-in-5 Americans. Spending surpassed $545 billion in 2015. Yet Medicaid, “the other M,” is often overshadowed by Medicare. Monday, June 12, 2017

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:

Democrats home in on opioid crisis in bashing proposed Medicaid cuts

Health and Human Services Secretary Tom Price defended the White House’s proposed cuts to Medicaid in its 2018 budget blueprint before a pair of congressional committees on Thursday, parrying blows from Democrats furious over spending reductions they say President Trump pledged on the campaign trail never to approve. StatNews. June 8, 2017

If Insurance Market Crashes, Can Lawmakers Put The Pieces Back Together?

In his high-stakes strategy to overhaul the federal health law, President Donald Trump is threatening to upend the individual health insurance market with several key policies. But if the market actually breaks, could anyone put it back together again?

Kaiser Health News. June 8, 2017

Anthem Will Exit Health Insurance Exchange in Ohio

Anthem, one of the nation’s largest insurers and a major player in the individual insurance market created by the federal health care law, announced Tuesday that it would stop offering policies in the Ohio marketplace next year. NYTimes. June 6, 2017

Feds To Waive Penalties For Some Who Signed Up Late For Medicare

Each year, thousands of Americans miss their deadline to enroll in Medicare, and federal officials and consumer advocates worry that many of them mistakenly think they don’t need to sign up because they have purchased insurance on the health law’s marketplaces. That decision can leave them facing a lifetime of enrollment penalties. Kaiser Health News. June 6, 2017

VA to adopt new electronic health records system in bid to improve care

Veterans Affairs Secretary David Shulkin said Monday the department will be overhauling its electronic health records, adopting a commercial product used by the Pentagon that he hopes will improve care for veterans and reduce wait times for medical appointments.

Stat News.  June 5, 2017

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. 

In your member enrollment process leaving you exposed?

By Claire Thayer, June 2, 2017

In September last year, the Government Accounting Office released a new study on findings from its undercover enrollment eligibility testing of federal and selected state marketplaces. As part of the study, GAO submitted 15 fake applications for subsidized coverage through the federal Marketplace in Virginia and West Virginia and through the state marketplace in California. GAO’s applications tested verifications related to (1) applicants’ making required income-tax filings, and (2) applicants’ identity or citizenship/immigration status. Through this extensive under cover testing process, GAO found that eligibility determination and enrollment processes continue to remain vulnerable to fraud.

This weeks’ edition of the MCOL Infographic, co-sponsored by LexisNexis, highlights some of findings presented in the GAO report: 

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

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:

The Fate of 16.8 Million Medicaid Enrollees Rests On 20 GOP Senators From 14 States

The Senate is on the verge of debating legislation to repeal and “replace” the Affordable Care Act, and Medicaid is on the chopping block. Huffington Post, June 2, 2017

Trump Rule Could Deny Birth Control Coverage to Hundreds of Thousands of Women

The Trump administration has drafted a sweeping revision of the government’s contraception coverage mandate that could deny birth control benefits to hundreds of thousands of women who now receive them at no cost under the Affordable Care Act. The New York Times, June 1, 2017

Ohio Sues 5 Major Drug Companies For 'Fueling Opioid Epidemic'

The state of Ohio has sued five major drug manufacturers for their role in the opioid epidemic. In the lawsuit filed Wednesday, state Attorney General Mike DeWine alleges these five companies "helped unleash a health care crisis that has had far-reaching financial, social, and deadly consequences in the State of Ohio." NPR, May 31, 2017

How plan for California gov't health care might be funded

A pending state Senate bill would provide government-funded universal health care for California's 39 million residents. The bill faces a Friday deadline for passage out of the Senate if it is to be considered by the state Assembly. ABC News, May 31, 2017

Drug Rebates Reward Industry Players — And Often Hurt Patients

Medicare and its beneficiaries aren’t the winners in the behind-the-scenes rebate game played by drugmakers, health insurers and pharmacy benefit managers, according to a paper published Tuesday in JAMA Internal Medicine. Kaiser Health News, May 30, 2017

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:

Top News From the Past Week as reported from key news services, and compiled by MCOL

Patient, Doctor Groups Say New CBO Score Reveals Health Care Bill's Flaws

Health care groups that represent doctors and patients are warning members of Congress that the House Republicans' plan to overhaul the Affordable Care Act would hurt people who need insurance most. NPR. Thursday, May 25, 2017

Senate to Start Drafting Health Care Bill Despite Policy Debates

Senate staffers will start to draft legislation that would repeal and replace significant parts of the Affordable Care Act next week, GOP senators said Thursday, despite the many differences among members of the caucus over policy. Morning Consult. Thursday, May 25, 2017

10 key points from the CBO report on Obamacare repeal

Here are some key facts and figures from the new CBO report on the American Health Care Act, the House-passed bill to repeal and replace Obamacare. CBO stressed the uncertainty of its estimates, given that it's hard to know which states would take up the chance to opt out of certain key parts of Obamacare. Politico Wednesday, May 24, 2017

Tab For Single-Payer Proposal In California Could Run $400 Billion

A proposed single-payer health system in California would cost about $400 billion annually, with up to half of that money coming from a new payroll tax on workers and employers, according to a state analysis. Kaiser Health News Tuesday, May 23, 2017.

Trump budget: $800 billion in Medicaid cuts

Donald Trump's budget that is expected to be unveiled on Tuesday will include $800 billion in cuts to Medicaid -- a move that underscores the President's resolve to significantly downsize the federal program even as Republican lawmakers are clashing over the issue in Congress. CNN Monday, May 22, 2017

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.