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Boston-based Steward Health Care System would become the largest for-profit hospital operator in the U.S. if it wins regulatory approval for a $2 billion merger with Franklin, Tennessee-based IASIS Healthcare. 

Policy uncertainty, changing reimbursement models and price transparency are just some of the topics expected to be discussed at the Healthcare Financial Management Association’s upcoming Annual National Institute, which runs from June 25 to 28 at the Orange County Convention Center in Orlando, Florida. 

Seventeen healthcare organizations have been named winners of the 2017 MAP Award for High Performance in Revenue Cycle by the Healthcare Financial Management Association (HFMA).

After losing in court for the third time over the $54 billion deal, Anthem has officially terminated its merger with Cigna, though the court battles involving the failed acquisition appear to be far from over.

The need for new or upgraded software, provider consolidation and hiring consultants are some of top trends practices will need to contend with as they prepare for the new payment tracks in the Medicare Access and CHIP Reauthorization Act (MACRA).

 

Recent Headlines

TeamHealth to pay $60 million to settle overbilling allegations

Physician staffing company TeamHealth has agreed to pay a $60 million penalty to settle allegations that one of its subsidiaries told hospitalists to “up-code” and overbill Medicare, Medicaid and other federal programs.

Healthcare consolidation isn’t driven by ACO participation

While the consolidation trend across healthcare accelerated after the Affordable Care Act (ACA) was passed, there's little evidence connecting consolidation to providers wanting to succeed under accountable care organization (ACO) programs created after the ACA, according to a study published in the February issue of Health Affairs.

Coding intensity could lead to $200 billion spending jump in Medicare Advantage

CMS will likely overpay Medicare Advantage plans by hundreds of billions of dollars over the next 10 years if the agency doesn’t account for coding intensity in its risk scores.

Group purchasing cuts costs, optimizes supply chain

A report from the Healthcare Supply Chain Association (HSCA) said the group purchasing organizations (GPOs) it represents help cut supply chain costs by an average of 15 percent and reduce drug spending by 25 percent.

3 ways to proactively identify underpayments before CMS audits

A Recovery Audit Contractor (RAC) review from CMS isn’t cause for celebration for most healthcare organizations, but it can be beneficial if those facilities take proactive steps to identify underpayments.

CMS proposes 0.25% increase in Medicare Advantage payments for 2018

CMS is offering a more modest 0.25 percent increase in payment rates for Medicare Advantage (MA) insurers, one year after a 0.85 percent hike, in its proposed MA update for 2018. 

Former Tenet exec indicted in $400 million Medicaid fraud case

John Holland, a former senior vice president for Tenet Healthcare’s southern region, has been charged with allegedly taking part in a scheme to pay bribes in exchange for patient referrals and resulting in $400 million in fraudulent Medicaid billings. 

Aetna CEO: ‘No intention’ of being in ACA market for 2018

Aetna CEO Mark Bertolini said the uncertainty surrounding the Affordable Care Act (ACA) and its insurance marketplace is too big of a risk for his company, saying it has “no intention of being in the market for 2018.”

How pulling Healthcare.gov ads could lead to insurer losses in 2017

The administration of President Donald Trump has cancelled advertisements and outreach efforts designed to encourage people to sign up on the health insurance marketplace in the final days of open enrollment, a move which could lead to a sicker, older risk pool for insurers. 

Court freezes CMS rule on premium assistance for dialysis patients

A federal judge has temporarily blocked a CMS rule on requiring dialysis companies to disclose all charitable premium assistance they provide to patients. 

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