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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

Trump talk: President-elect's promise to control drug prices tanks biotech stocks

Biotech stocks fell nearly 5 percent Dec. 7, after Time magazine published an interview with President-elect Donald Trump's interview with Time magazine, in which he vowed to take action to control drug prices.

Aetna argues federal case against Humana merger based on ‘pretend world’

The antitrust trial on Aetna’s proposed $37 billion acquisition of Humana began Dec. 5, with the U.S. Department of Justice beginning to make its case that the merger would reduce competition and raise prices for patients and hospitals.

Medicaid admissions can lead to profits, thanks to Medicare

Adding one Medicaid patient day in 2017 would increase a hospital’s Medicare payments by more than $300, which, when added to Medicaid dollars, makes treating Medicaid beneficiaries profitable for hospitals.

Taxes, fees take bite out of Medicaid DSH payments

Disproportionate-share hospitals (DSHs) couldn’t cover their total costs for treating Medicaid and uninsured patients in 2011 through Medicaid payments, after accounting for taxes and fees paid to local governments.

FTC urges Tennessee regulators to reject Wellmont-Mountain States merger

The proposed merger of Mountain States Health Alliance and Wellmont Health System was mostly supported by public comments at a Tennessee hearing, but the Federal Trade Commission (FTC) urged regulators to block the deal.

Medicaid pass-through payments would be limited under CMS proposal

CMS has proposed a new rule which would prevent states from creating or increasing Medicaid “pass-through” reimbursements for services unrelated to value-based payment or care delivery.

Anthem opens merger trial arguing Cigna purchase would improve rates

The antitrust trial between the U.S. Department of Justice (DOJ) and Anthem over its proposed $54 billion acquisition of Cigna began Nov. 21, with both sides offering conflicting visions of insurance competition if the deal were allowed to go through.

22 percent of ED visits result in ‘surprise’ out-of-network charges

Patients who went to an in-network emergency department (ED) were treated by an out-of-network physician 22 percent of the time, resulting in hundreds of thousands of dollars in unexpected medical bills.

Advocate, NorthShore merger moving ahead despite court loss

A deal to create the 11th largest nonprofit hospital system in the U.S. is going forward despite courts siding with the Federal Trade Commission on temporarily blocking the merger.

How drug price hikes affect Medicare, Medicaid

Steep price hikes for a number of prescription drugs led to big increases in Medicaid and Medicare spending in 2015, according to data released by CMS.

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