Week in Review | April 14, 2018

Phoenix’s Banner Health has agreed to pay more than $18 million to settle a whistleblower lawsuit alleging it overcharged Medicare by admitting patients at hospitals for brief, inpatient services when they could’ve been treated in less expensive outpatient settings.

Prices across the healthcare sector rose 2.2 percent year-over-year in March 2018, the highest annual growth rate recorded by Altarum since January 2012, with the report warning rapid price growth is likely to continue.

The report from the Health Care Cost Institute (HCCI) examined claims for people with multiple sclerosis (MS) from 2009 to 2015 covered by individual market, employer-sponsored or Medicare Advantage plans. It found total spending per MS patient rose from around $23,900 to $39,628 by 2015. During the same time period, the share of spending spent towards injectable and oral disease modifying therapies (DMTs) rose from 39 percent to 53 percent.

The underlying causes haven’t changed behind the shortage of doctors in the United States: The population aged 65 and over is expected to grow by 50 percent by 2030, increasing demand for healthcare services. The physician population is also aging, with 13.5 percent of the active workforce already aged 65 and over and another 27.2 percent between the ages of 55 and 64.

Verizon’s 2018 Data Breach Investigations Report mirrored what was released last month in its report on breaches involving protected health information (PHI) in prior years. Whereas all other industries profiled—including education, financial and retail—saw the majority of their breaches come from external forces, most of the healthcare industry’s threats came from inside.

What will keep early career physicians from leaving a hospital or health system may differ between men and women, according to a survey from CompHealth. Regardless of gender, most physicians said they’re finding jobs the old-fashioned way: referrals and networking.

A survey from Black Book Research found when healthcare organizations don’t have a master patient database across various departments, match rates when exchanging records with other health systems are much lower.

Meadows Regional Medical Center in Vidalia, Georgia, serves a “very rural” area, according to president and CEO Alan Kent, DHA, just the kind of facility that has often been scooped up by larger systems in recent years. Staying independent meant the hospital needed to drive through a series of management-led initiatives on quality, patient growth and staffing levels.

In a survey of 232 chief nursing officers (CNOs) by AMN Healthcare, the vast majority said they’re experiencing at least a moderate shortage of nurses at their organizations—and 61 percent expected it would only get worse in the next five years.

In a final rule that CMS said would help customers “suffering from high Obamacare premiums,” the agency’s 2019 rule for the Affordable Care Act (ACA) exchanges would give states more power on how plans cover required benefits and widen exemptions to the law’s individual mandate in the final year customers can be penalized for not having ACA-compliant insurance.