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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

4% increase for most Medicare Part B premiums for 2017

CMS has announced premiums and deductibles for Medicare Parts A and B for 2017, with modest increases for most beneficiaries.

Kindred getting out of nursing home business

Louisville, Kentucky-based Kindred Healthcare will be divesting its skilled nursing facilities to focus on more profitable business segments like long-term acute care and rehabilitation hospitals.

$140 million boost to primary care reimbursement in final 2017 Medicare PFS

The final version of the Medicare Physician Fee Schedule (PFS) released by CMS could direct an extra $140 million to primary care physicians in 2017, though it’s receiving some mixed reviews from major medical groups.

Narrow exceptions offered in final site-neutral payment rule from CMS

CMS has finalized the rule changing how hospital off-campus facilities are reimbursed within its 2017 hospital Outpatient Prospective Payment System (OPPS) changes, largely ignoring concerns from the American Hospital Association about the impact of site-neutral payment.

New results, requirements for CMS's hospital value-based purchasing program

Most hospitals will see an increase in their fiscal year 2017 Medicare Severity Diagnosis-Related Group (MS-DRG) payments under CMS’s Hospital Value-Based Purchasing (VBP) program.

CMS finalizes smaller drop in pay for Medicare home health

Home health agencies will receive $130 million less in Medicare reimbursements for 2017, the final year of reductions meant to recoup overpayments dating back to 2000.

3 things to know: HHS report measures progress toward value-based care

Healthcare is on its way to achieving value-based care goals, according to a new report from HHS’s Health Care Payment Learning and Action Network (LAN).

Catholic Health Initiatives, Dignity Health exploring merger

Nonprofit health systems Catholic Health Initiatives (CHI) and Dignity Health have “signed a non-binding letter of intent” to merge, which could create one of the largest nonprofit hospital chains by revenue in the U.S.

CMS opens more alternative payment models for MACRA bonus

CMS is offering more paths for practices and payers to earn incentive payments under the Medicare Access and CHIP Reauthorization Act (MACRA).

ACA exchange enrollment could decrease in 2017

The fourth year of open enrollment in the Affordable Care Act (ACA) insurance marketplaces could see a “significant slowdown” in how many people purchase coverage, according to an analysis from Standard and Poor’s.

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