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The Rural Community Hospital Demonstration Program, which aims to test payments to rural facilities under a “reasonable cost-based methodology” for Medicare inpatient services, has 17 returning and 13 new participants as part of a five-year extension of the program.

A California judge ruled Sacramento-based Sutter Health “intentionally destroyed” 192 boxes of documents which were sought in an antitrust lawsuit against the not-for-profit health system.

Shareholders of the Advisory Board Company signed off on the $1.3 billion sale of its healthcare division to UnitedHealth Group’s Optum health services segment.

Policymakers may think elderly Americans should be satisfied with their Medicare coverage, but, according to new research from the Commonwealth Fund, they come in last place when compared to senior healthcare in 10 other countries.

Price growth in healthcare was at a 1.1 percent annual rate as of Sept. 2017 compared to the year prior, according to the Altarum Institute, coming close to the all-time low of 0.9 percent annual growth seen in Dec. 2015.

 

Recent Headlines

Some 2018 MIPS bonuses may not be worth the investment

A bonus of up to 10 percent has been proposed for using an upgraded electronic health record (EHR) system for reporting in the Merit-based Incentive Payment System (MIPS) in 2018, but speakers at two recent industry conventions warned it’s likely not a worthwhile investment for providers.

Bundled payment cancellation by CMS draws calls for new Advanced APMs

When the previous administration at CMS finalized rules on mandatory bundled payment models for cardiac and orthopedic care late in 2016, 221 public comments were received. The cancellation of those same bundles, however, drew only 85 official comments as of Oct. 18.

Positive results for ACO models, but CMS doesn’t publicize results

Four accountable care organization (ACO) models generated more in gross savings in 2016, but unlike in previous years, CMS hasn’t publicly touted the results as it re-examines payment models created under the Centers for Medicare and Medicaid Innovation (CMMI).

DOJ drops Medicare Advantage fraud suit against UnitedHealth

The U.S. Department of Justice (DOJ) has abandoned a lawsuit against UnitedHealth over allegations the insurer submitted false claims in its Medicare Advantage plans, though a similar case remains active.

MGMA17: Pros and cons of selling a practice to private equity

Private investors are becoming increasingly active in healthcare acquisitions, which may maximize the purchase price when practices decide to sell, but there are downsides to these transactions compared to be absorbed into a hospital or health system.

Donations to U.S. nonprofit hospitals up 5% in 2016

Nonprofit hospitals and health systems in the U.S. raised more than $10.1 billion in fiscal year 2016, a 5 percent jump from the year before, while their Canadian counterparts saw their first increase in donations since 2013.

Q&A: What could a ‘new direction’ mean for CMMI’s payment reforms?

The new administration at CMS and HHS has signaled it wants to take a different path on value-based care models. Some have been clear actions, like ending mandatory bundled payment models in cardiac care. The next step may be more driven by stakeholders, as CMS recently released a request for information (RFI) asking what new models developed by the Centers for Medicare and Medicaid Innovation (CMMI) should look like.

6 stats from JPMorgan Chase study of 2.3M families’ healthcare spending

The JPMorgan Chase Institute Healthcare Out-of-pocket Spending Panel (JPMCI HOSP) included 2.3 anonymized Chase customers from 18 to 64 years old between 2013 and 2016. The study examined trends in out-of-pocket healthcare spending in 23 of the 50 United States and their effects on household financial standings.

Providers lagging behind offering payment options patients want

Patients are expecting more flexible payment options, both in terms of how and when they pay their balances. Yet hospitals—and to a slightly lesser extent group practices—don’t appear to be providing all the tools patients have requested, according to a survey released by the Medical Group Management Association (MGMA) and Navicure.

267,000 healthcare jobs would be eliminated under latest ACA repeal plan

The Graham-Cassidy legislation to repeal the Affordable Care Act (ACA) would cause an immediate downturn in healthcare employment, amounting to more than 267,000 fewer jobs in the industry by 2026, according to a report from George Washington University’s Milken Institute School of Public Health and the Commonwealth Fund.

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