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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

Hospital budgets challenged by unpredictable increases in drug costs

Hospital spending on inpatient drugs went up by an average of 38.7 percent per admission and 23.7 percent annually between 2013 and 2015, according to a study from the American Hospital Association and the Federation of American Hospitals.

House Republicans could sue HHS over rumored risk corridor settlements

Rep. Chris Stewart, R-Utah, is circulating a letter among members of his party calling for a lawsuit against HHS to block the agency from settling legal disputes with insurers over the Affordable Care Act’s risk corridor program.

Ardent, LHP to merge into second-largest private for-profit hospital chain

Nashville, Tennessee-based Ardent Health Services and LHP Hospital Group of Plano, Texas, have entered into a merger agreement, the companies announced Oct. 5.

UC Irvine Health laying off 175 employees

UC Irvine Health will let go 175 employees, along with another 79 vacant positions being eliminated.

Tenet to pay $513 million to settle referral kickback case

Tenet Healthcare Corporation and two of its subsidiaries in Atlanta will pay a total of $513 million to settle both civil and criminals charges of kickbacks and bribes being paid in exchange for Medicaid patient referrals.

Integrated systems, hospitals losing more money than private practices

Integrated health systems posted operating losses of approximately $210,000 per physician in 2015 compared to $14,000 per physician in private practices, according to a survey from the American Medical Group Management Association (AGMA), with hospitals' medical practice subsidiaries losing $250,000 per physician. 

Not-for-profit hospitals improved financially in 2015—but analysts say it won’t last

The operating performance for not-for-profit hospitals improved “across the board” in fiscal year 2015, according to Fitch Ratings, but those figures are expected to drop off in 2016 and 2017 thanks to changes in CMS reimbursement.

Community Health selling four rural hospitals

Community Health Systems (CHS), one of the largest hospital chains in the U.S., has announced the sale of four rural hospitals as it tries to relieve some of its $15 billion debt.

Medicare spending on EpiPens went up 1,100% between 2007 and 2014

The rising price for EpiPens since the autoinjector device was acquired by Mylan in 2007 can’t come close to the increase in how much Medicare Part D spends on it, according to an analysis from the Kaiser Family Foundation.

CMS’s voluntary bundled payment evaluation finds uneven results

The evaluation of models 2-4 of Medicare’s Bundled Payments for Care Improvement (BPCI) initiative highlighted mixed results on savings and quality in the first 15 months of the program.

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