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Pharmacy benefits manager Express Scripts said it will lose Anthem as a client when its current contract expires at the end of 2019, claiming it can’t agree to the price concessions Anthem has been demanding.

Medical equipment giant Becton, Dickinson and Co. (BD) is getting bigger, announcing a $24 billion cash-and-stock deal to acquire CR Bard, including its portfolio in oncology, vascular and surgical products.

Mergers and acquisition (M&A) activity in healthcare isn’t slowing down, with the first quarter of 2017 being the tenth straight with more than 200 deals. What did change, according to a report from PricewaterhouseCoopers (PwC), was the disclosed value of those transactions.

HHS Secretary Tom Price and CMS Administrator Seema Verma have both expressed skepticism about making bundled payments mandatory for providers in certain regions, but switching them to voluntary participation could slow the transition to value-based care, according to five Brookings Institution experts writing in a Health Affairs blog post.

Despite claims by President Donald Trump, Republican members of Congress, and some insurance CEOs, the Affordable Care Act (ACA)’s health insurance exchanges aren’t in a death spiral, according to a Standard and Poor’s (S&P) analysis, which predicts the individual market is actually on a path to profitability in 2018.

 

Recent Headlines

Utilizing hospitals’ internal cost data could improve accuracy of new payment models

In an attempt to obtain greater accuracy on cost estimates, hospitals have developed their own internal systems to identify services with high and low profit margins and control spending. If what they’ve come up with is more detailed than what CMS uses, shouldn’t CMS be using that data?

Massachusetts hospital blamed for Medicare underpayments in other states

Miscalculations by Nantucket Cottage Hospital in Massachusetts in wages and costs in 2015 resulted in Medicare paying all hospitals in the state $133 million more than it should—creating a chain reaction that resulted in hospitals around the country being underpaid by CMS.

Pinnacle to affiliate with UPMC, buy 4 hospitals

Harrisburg, Pennsylvania-based Pinnacle Health announced it will more than double the number of hospitals within its system while also beginning an affiliation with the state’s largest health system, University of Pittsburgh Medical Center (UPMC). 

Fairview, HealthEast plan merger into 11-hospital system in Minnesota

Fairview Health Service and HealthEast Care System have announced their intention to merge, creating what is likely the largest health system in the Minneapolis-St. Paul area with a combined $5 billion in annual revenue.

Advocate, NorthShore scrap merger plans

A merger between two Illinois hospital systems, Advocate Health Care and NorthShore University Health Care, has been called off after a federal judge granted the Federal Trade Commission (FTC) a preliminary injunction against the deal.

McKesson, Change Healthcare finalize new IT company

The creation of a new data and analytics company, combining McKesson’s technology solutions unit with Nashville, Tenn.-based Change Healthcare, has been completed. The merger unites “the majority” of McKesson Technology Solutions with substantially all of Change, with the new company retaining the Change Healthcare name and Neil de Crescenzo as CEO.

Healthcare spending projected to make up almost 20% of U.S. economy by 2026

Health expenditures in the U.S. are expected to grow by an average of 5.6 percent annually through 2025, driven by rising medical prices that won’t be offset by slower growth in other areas.

Dueling lawsuits: Cigna wants $15 billion from Anthem; Anthem claims ‘sabotage’ of $54 billion merger

After their proposed merger was blocked by a federal judge, insurers Anthem and Cigna now have new opponents in court: each other.

Humana exiting ACA exchanges, individual market in 2018

Humana will be leaving all Affordable Care Act (ACA) exchanges and withdraw all its business from the individual insurance market in 2018, becoming the first major insurer to make a full exit amid uncertainty about the law’s future. 

Anthem files for expedited appeal of decision blocking Cigna merger

Anthem is asking the D.C. Circuit Court of Appeals to rush the appeals process as it tries to reverse a lower court’s ruling blocking its $54 million of acquisition of Cigna.

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