| Editor's Choice: Economics | The deal will still need to be approved by federal and state regulators, but after delays in contract talks and an unsolicited bid from Brown University, the agreement advances Partners HealthCare’s aim of expanding beyond Massachusetts and matching the increased scale of other Boston-based health systems. The deal will still need to be approved by federal and state regulators, but after delays in contract talks and an unsolicited bid from Brown University, the agreement advances Partners HealthCare’s aim of expanding beyond Massachusetts and matching the increased scale of other Boston-based health systems. | |
| The legislation, sponsored by California Assemblyman Ash Kalra, a Democrat from San Jose, would have created a state commission to set rates for many medical services currently covered by private insurers in the group and nongroup markets. The legislation, sponsored by California Assemblyman Ash Kalra, a Democrat from San Jose, would have created a state commission to set rates for many medical services currently covered by private insurers in the group and nongroup markets. | |
| The Congressional Budget Office has scaled back its projections of coverage losses from the Affordable Care Act’s individual mandate being repealed, estimating 8.5 million people will be uninsured in 2027 due to the penalty being eliminated by Republicans’ tax legislation beginning next year. The Congressional Budget Office has scaled back its projections of coverage losses from the Affordable Care Act’s individual mandate being repealed, estimating 8.5 million people will be uninsured in 2027 due to the penalty being eliminated by Republicans’ tax legislation beginning next year. | |
| UnitedHealth said it costs an average of $9,400 annually to cover a low-income, subsidized enrollee on the marketplace with $7,000 of that cost falling on the federal government. For someone eligible for Medicaid thanks to the Affordable Care Act (ACA), the overall cost is $5,400—with $5,100 coming from federal funds. UnitedHealth said it costs an average of $9,400 annually to cover a low-income, subsidized enrollee on the marketplace with $7,000 of that cost falling on the federal government. For someone eligible for Medicaid thanks to the Affordable Care Act (ACA), the overall cost is $5,400—with $5,100 coming from federal funds. | |
| TransUnion Healthcare has announced the acquisition of reimbursement technology company Healthcare Payment Solutions (HPS). Adding HPS solutions to its portfolio will boost TransUnion’s position in the post-discharge revenue recovery technology market, the company said. TransUnion Healthcare has announced the acquisition of reimbursement technology company Healthcare Payment Solutions (HPS). Adding HPS solutions to its portfolio will boost TransUnion’s position in the post-discharge revenue recovery technology market, the company said. | |
| Three sponsors of Medicare Part D plans—UnitedHealth Group, Humana and CVS Health—account for more than half the program’s total enrollment. If proposed mergers involving smaller players like Aetna, Express Scripts and Cigna move ahead, the market would become even more concentrated. Three sponsors of Medicare Part D plans—UnitedHealth Group, Humana and CVS Health—account for more than half the program’s total enrollment. If proposed mergers involving smaller players like Aetna, Express Scripts and Cigna move ahead, the market would become even more concentrated. | |
| Primary care physicians and non-physician practitioners have seen their compensation rise more rapidly than specialists, which the Medical Group Management Association (MGMA) said is evidence of the worsening shortage of primary care doctors. Primary care physicians and non-physician practitioners have seen their compensation rise more rapidly than specialists, which the Medical Group Management Association (MGMA) said is evidence of the worsening shortage of primary care doctors. | |
| CMS has approved an extension of Maryland’s model of offering a fixed payment for most hospital services, allowing physician practices and nursing homes to voluntarily participate in a program that has saved Medicare hundreds of millions of dollars. CMS has approved an extension of Maryland’s model of offering a fixed payment for most hospital services, allowing physician practices and nursing homes to voluntarily participate in a program that has saved Medicare hundreds of millions of dollars. | |
| Year-over-year price growth was 2.2 percent in April 2018, which Altarum said was fractionally above the March rate, setting a six-year high for price growth in the sector. Hospital price growth fell slightly to 3.7 percent. Year-over-year price growth was 2.2 percent in April 2018, which Altarum said was fractionally above the March rate, setting a six-year high for price growth in the sector. Hospital price growth fell slightly to 3.7 percent. | |
| When hospitals enjoy a monopoly in their market, their prices for privately insured patients are 12.5 percent higher on average, according to a study encompassing 88 million people covered by Aetna, Humana and UnitedHealthcare. The differences disappeared when consolidating facilities were located more than 25 miles apart. When hospitals enjoy a monopoly in their market, their prices for privately insured patients are 12.5 percent higher on average, according to a study encompassing 88 million people covered by Aetna, Humana and UnitedHealthcare. The differences disappeared when consolidating facilities were located more than 25 miles apart. | |
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