| This Week’s News | Sen. Bill Cassidy, MD, R-Louisiana, released a series of new healthcare proposals that would expand insurance which doesn’t comply with the Affordable Care Act, along with new ideas on requiring price transparency and incentivizing care settings that are less expensive than hospitals. Sen. Bill Cassidy, MD, R-Louisiana, released a series of new healthcare proposals that would expand insurance which doesn’t comply with the Affordable Care Act, along with new ideas on requiring price transparency and incentivizing care settings that are less expensive than hospitals. | |
| The American Medical Association (AMA) released a report on May 31 detailing how “physician leadership” has led to progress fighting the epidemic of opioid abuse and addiction. Just two days earlier, however, a story published by the Daily Beast labeled the AMA as a main roadblock to Congress addressing the prescription of opioids. The American Medical Association (AMA) released a report on May 31 detailing how “physician leadership” has led to progress fighting the epidemic of opioid abuse and addiction. Just two days earlier, however, a story published by the Daily Beast labeled the AMA as a main roadblock to Congress addressing the prescription of opioids. | |
| New Jersey will maintain the penalty on a statewide level in 2019. Vermont's law will take more time, with a working group tasked with figuring out how to enforce the mandate beginning in 2020. New Jersey will maintain the penalty on a statewide level in 2019. Vermont's law will take more time, with a working group tasked with figuring out how to enforce the mandate beginning in 2020. | |
| The Medicare Payment Advisory Commission (MedPAC) has added five new members, including a former head of the Office of the National Coordinator for Health IT (ONC) and chief medical officers at HCA Healthcare and Geisinger Health System. The Medicare Payment Advisory Commission (MedPAC) has added five new members, including a former head of the Office of the National Coordinator for Health IT (ONC) and chief medical officers at HCA Healthcare and Geisinger Health System. | |
| The $1.6 billion in cuts to Medicare payments made under the 340B drug discount programs could add to the financial stress of smaller not-for-profit hospitals and health systems, according to Standard & Poor (S&P)’s Global Ratings. The $1.6 billion in cuts to Medicare payments made under the 340B drug discount programs could add to the financial stress of smaller not-for-profit hospitals and health systems, according to Standard & Poor (S&P)’s Global Ratings. | |
| Athenahealth CEO Jonathan Bush issued an apology for “regrettable incidents” after it was reported he had admitted to assaulting his now former wife, but he’ll remain CEO of the health IT company as its under pressure to accept a takeover bid from activist hedge fund manager Paul Singer. Athenahealth CEO Jonathan Bush issued an apology for “regrettable incidents” after it was reported he had admitted to assaulting his now former wife, but he’ll remain CEO of the health IT company as its under pressure to accept a takeover bid from activist hedge fund manager Paul Singer. | |
| One of the largest insurers in the U.S. behind the Big Five of UnitedHealthcare, Aetna, Anthem, Cigna and Humana, WellCare would add more Medicaid and Medicare Advantage (MA) members with the purchase of Meridian Health Plans. One of the largest insurers in the U.S. behind the Big Five of UnitedHealthcare, Aetna, Anthem, Cigna and Humana, WellCare would add more Medicaid and Medicare Advantage (MA) members with the purchase of Meridian Health Plans. | |
| 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. | |
| Total community benefit spending increased from $15.3 billion in 2012 to $18.4 billion in 2015—a 20.14 percent jump in terms of the raw dollars and a 15 percent increase after adjusting for inflation. Total community benefit spending increased from $15.3 billion in 2012 to $18.4 billion in 2015—a 20.14 percent jump in terms of the raw dollars and a 15 percent increase after adjusting for inflation. | |
| Michael Frank has worked for health insurance companies for decades, doing the actuarial science which determines how much people should pay in monthly premiums. He knows insurers are supposed to be his “advocate” to restrain costs and get him a fair rate—so he was shocked when Aetna agreed to pay $70,000 to NYU Langone Medical Center in New York City for his partial hip replacement. Michael Frank has worked for health insurance companies for decades, doing the actuarial science which determines how much people should pay in monthly premiums. He knows insurers are supposed to be his “advocate” to restrain costs and get him a fair rate—so he was shocked when Aetna agreed to pay $70,000 to NYU Langone Medical Center in New York City for his partial hip replacement. | |
| CMS had requested comments on allowing direct provider contracting (DPC) with Medicare beneficiaries in the form of the alternative payment model. Among major healthcare groups, the response was decidedly mixed, ranging from cautious optimism to telling CMS to focus on other payment reforms. CMS had requested comments on allowing direct provider contracting (DPC) with Medicare beneficiaries in the form of the alternative payment model. Among major healthcare groups, the response was decidedly mixed, ranging from cautious optimism to telling CMS to focus on other payment reforms. | |
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