Policy & Regulations

This channel includes news coverage of healthcare policy and regulations set by Congress, the states, Centers for Disease Control and Prevention (CDC), the Department of Health and Human Services (HHS), U.S. Food and Drug Administration (FDA), and medical associations and societies. 

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Out-of-pocket costs have little to do with price of procedures

As hospitals start to publish prices of their services, patients should theoretically be able to save money by shopping around. However, out-of-pocket costs to patients have little correlation with the amount insurers pay or the overall price of a procedure, according to a recent study of 14 representative Massachusetts hospitals by Pioneer Institute.

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Physicians generate $2.4M for hospitals annually

Physicians are major drivers of hospital revenue, generating about $2.4 million each year, according to a new survey from Merritt Hawkins.

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DOJ asks court for final approval of CVS-Aetna deal

The Department of Justice has asked a judge to approve the $69 billion merger between CVS Health and Aetna, which was closed by the two companies at the end of 2018, Reuters reported. The deal has been hung up on court approval, though it has been approved by all other regulators and the DOJ.

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More employers integrating healthcare benefits

More employers are actively integrating or considering integrating their medical, pharmacy, dental, vision and/or disability benefits under their health and wellness programs in the next five years thanks to the positive impact on employees, a study from Anthem found. 

Crossover Health Acquires Sherpaa Health Virtual Primary Care Platform

Crossover Health, a leading provider of comprehensive health services for self-insured employers, announced today that it has acquired the exclusive rights to the technology platform developed by Sherpaa Health, the pioneer of virtual primary care.

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GE to sell biopharma biz for $21B, postpone healthcare IPO

General Electric Company (GE) is selling its biopharma business to Danaher for $21.4 billion, the company announced Feb. 25. With a definitive agreement signed between the two parties, GE’s previous plan to spin off its healthcare sector with its own initial public offering is likely put on hold, GE Chairman and CEO Larry Culp told CNBC.

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Report reveals drug middlemen snagged $124M in Kentucky

Drug middlemen gobbled up $123.5 million in hidden costs in Kentucky’s Medicaid program, according to a new report from the Kentucky’s Cabinet for Health and Family Services.

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Cigna, Anthem dispute bills after failed merger

A proposed merger between two major health insurance providers ended in a messy breakup after antitrust issues prohibited the roughly $50 billion transaction in 2017. Now, the two companies, Anthem and Cigna, are still disputing which company will foot the costs of the failed deal, Bloomberg Quint reported.

Around the web

Compensation for heart specialists continues to climb. What does this say about cardiology as a whole? Could private equity's rising influence bring about change? We spoke to MedAxiom CEO Jerry Blackwell, MD, MBA, a veteran cardiologist himself, to learn more.

The American College of Cardiology has shared its perspective on new CMS payment policies, highlighting revenue concerns while providing key details for cardiologists and other cardiology professionals. 

As debate simmers over how best to regulate AI, experts continue to offer guidance on where to start, how to proceed and what to emphasize. A new resource models its recommendations on what its authors call the “SETO Loop.”