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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

Analyst Forecasts Continuing Headwinds in Health-care Financial Markets

Consolidation, the implementation of the Patient Protection and Affordable Care Act (PPACA), and efforts to use capitation for Medicare patients will all have an impact on health-related stocks, over then next few years.

Serving Low-income Patients Inland Empire Health Plan’s PPACA Strategy

One of the most contentious issues associated with the Patient Protection and Affordable Care Act (PPACA) has been the creation of health insurance exchanges (HIEs), which must be composed entirely of private health insurers. While many states have resisted participation, others, like California, have begun building an exchange.

M&A Part II: Practical Considerations of the Deal

In the hospital space, as in other markets, mergers and acquisitions (M&A) can be fraught with emotion. However, setting feelings aside and concentrating on practical matters—especially unique challenges that are inherent in merging with or acquiring a particular type of institution—are essential to deal-making success.

Vetting a Partnership: When to Consider a Merger or Acquisition

Health care reform has catalyzed providers—especially independent hospitals—to consider the business models and structures within which they will operate going forward. As such, many will contemplate mergers or acquisitions, but there is much to consider before pursuing such a path.

WellPoint Founder: Health Reform Law Is Not Enough

Leonard Schaeffer, founding CEO and former chairman of WellPoint insurance company, gave a sobering opinion on the ability of the federal reform legislation to bend the health care cost curve at The 8th Annual American Health Care Congress and Exhibition.

Hospital Employment: What Hospitals and Physicians Should Know

American physicians are again rushing to become employed by hospitals—and hospitals are responding in kind, says D. Louis Glaser, JD, partner with Katten Muchin Rosenman LLP in Chicago, Illinois. "The trend is being driven by the uncertainty of the future," he says. "Physicians and hospitals are wondering how reimbursement is going to change,

OhioHealth: Creating a High-performance Revenue Cycle

When Jane Berkebile, vice president of revenue cycle for OhioHealth (Columbus, Ohio), joined the organization five years ago, she was already impressed by its revenue cycle performance. “The triad for success, as I call it, was up and running when I came here: patient access, medical records, and business office activities were all reporting to the

Leadership and Succession Planning for Health Care

Multiple factors stand to shake up health care organizations' leadership structures in the coming years, says Will Powley, senior consulting leader with GE Healthcare's Performance Solutions group: economic recovery, health care reform, and, perhaps with the most impact, the impending retirement of the Baby Boomer generation. Combined, these three

Improving Financial Performance Through Employee Engagement: BHS Case Study

By early 2007, Birmingham, Alabama-based Baptist Health System (BHS) was facing significant systemic problems with its staff and management—problems that were creating tough-to-surmount financial repercussions. Alan Bradford, chief human resource officer at BHS, clearly recalls the difficulties the organization was facing: "The momentum of the

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