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A bonus of up to 10 percent has been proposed for using an upgraded electronic health record (EHR) system for reporting in the Merit-based Incentive Payment System (MIPS) in 2018, but speakers at two recent industry conventions warned it’s likely not a worthwhile investment for providers.

When the previous administration at CMS finalized rules on mandatory bundled payment models for cardiac and orthopedic care late in 2016, 221 public comments were received. The cancellation of those same bundles, however, drew only 85 official comments as of Oct. 18.

Four accountable care organization (ACO) models generated more in gross savings in 2016, but unlike in previous years, CMS hasn’t publicly touted the results as it re-examines payment models created under the Centers for Medicare and Medicaid Innovation (CMMI).

The U.S. Department of Justice (DOJ) has abandoned a lawsuit against UnitedHealth over allegations the insurer submitted false claims in its Medicare Advantage plans, though a similar case remains active.

Private investors are becoming increasingly active in healthcare acquisitions, which may maximize the purchase price when practices decide to sell, but there are downsides to these transactions compared to be absorbed into a hospital or health system.

 

Recent Headlines

Threat of FTC denial scuttles Indiana hospital, physician group merger

Beacon Health System and the South Bend Clinic physician group have suspended their merger plans because of a longer than expected Federal Trade Commission (FTC) review and uncertainty over whether the deal would be approved.

ACA hits nation’s largest insurer’s bottom line

First quarter earnings for UnitedHealth Group Inc. show a 7.8 percent drop, reflecting in part the cuts to Medicare Advantage programs, new taxes and additional regulation created by the implementation of the Patient Protection and Affordable Care Act, the company said.

Physicians contributed $1.6 trillion to economy in 2012

A new report commissioned by the American Medical Association attempts to quantify the direct and indirect economic output of physicians in order to educate policy makers and the public.

Kansas cancer center settles with DOJ for $2.9 million

Hope Cancer Institute in Kansas City and its owner Raj Sadasivan, M.D., were accused of submitting Medicare claims for chemotherapy drugs that were never provided.

Lowell General Hospital and Tufts Medical Center form new health system

Boston’s prestigious Tufts Medical Center teaching hospital will partner with Lowell General Hospital, a community hospital with two campuses in Lowell, Mass., under a new parent company yet to be named.

ACA could raise your malpractice insurance rates

A key element of healthcare is leveraging technology and system efficiencies to allow individual providers to see more patients. But as the number of patients goes up, so does a provider’s malpractice risk according to a new study from the RAND Corporation.

Mergers and acquisitions continue at fast pace, especially for not-for-profits

A new report by independent consulting firm Kaufman Hall finds that U.S. hospital merger and acquisition activity increased 3 percent in 2013, with deals announced for 98 hospital and health system combinations.

Massachusetts state officials working to re-open bankrupt rural hospital

The abrupt closure of North Adams Regional Hospital in the rural community of North Adams, Mass., created a public outcry and has gotten legislators and policy makers involved in trying to broker a deal whereby another health system may be able to take over and re-open the facility.

ICD-10 delay positive for not-for-profit hospitals says finance firm

Credit ratings and research firm Fitch Ratings has analyzed the one-year delay on ICD-10 implementation and come to the conclusion that it will help more than hurt the finances of not-for-profit hospitals.

SC health system loses right to build new hospital to Tenet competitor

South Carolina’s fractured certificate of need (CON) process for new hospital construction has led to a protracted fight over who would be allowed to build a new hospital in Fort Mill, S.C. On Tuesday, a judge took the CON last awarded to Carolinas HealthCare System in 2011 and handed it to competitor Piedmont Medical Center, a hospital operated by a Tenet Healthcare subsidiary.

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