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Entries in Current News (112)

Thursday
Mar122020

Five Questions for Rachel Sokol with Advisory Board on Frictionless Healthcare Experiences

By Claire Thayer

Rachel Sokol, Managing Director, Payer Research, Advisory Board participated in a Healthcare Web Summit webinar on The Financial Case for a Frictionless Experience.  The discussion highlighted several areas of frictions that highly impact cost of care use, satisfaction and retention efforts and where payers and health systems might think about prioritizing their experience improvement initiatives. If you missed this engaging webinar presentation, you’ll want to be sure to watch the Webinar Video. After the webinar, we interviewed Rachel on five key takeaways: 
 

1. What are a few of the common consumer experience initiatives that health plans are investing in?

Rachel Sokol: The biggest investments we see from plans center around the digital experience – so many plans building new websites, member-only portals, and apps.

2. Your focus of the presentation is on member friction and how this correlates with costly care use. How do you define “friction” from the consumer’s perspective?

Rachel Sokol: We define a “friction” as anything that prevents a consumer from easily and intuitively achieving their goals causing the consumer to hesitate or abandon the health care interaction altogether.

3. Continuing with the discussion on "friction" - what are some of the friction points that would result in a health plan member choosing to go out of network for care services?

Rachel Sokol: The biggest frictions we see leading to out of network use are discrepancies between what the insurer and what the provider say regarding service or physician coverage.

4. Your study points out that members aren't willing to wait for care, even at convenient sites like urgent care and telehealth.  What insights or suggestions do you have for health plans to improve member access?

Rachel Sokol: We’d suggest that plans make it easier for members to access these sites by pre-registering them wherever possible and making the process as familiar as they can with training and promotional materials.

5. To best manage the full member experience cycle, do health plans need to own physician practices in order to reach high levels of member service standards?

Rachel Sokol: Plans don’t have to own practices to offer a seamless experience – but if they don’t, they’ll need a strategy to compete with the expectations set by those that do.  If not ownership, close partnership will be essential to making sure that members have access to high value physicians ready to provide personalized care.

Friday
Nov012019

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

 

Google to acquire Fitbit in $2.1B deal, challenging Apple

Google plans to acquire wearables maker Fitbit in a deal valued at $2.1 billion, the companies announced Friday. Fitbit's stock soared more than 16% on the news.

Healthcare Dive

Friday, November 1, 2019

IBM, Mayo Clinic, Geisinger among 25 finalists for $1.6M CMS artificial intelligence challenge

Out of more than 300 artificial intelligence proposals, the Centers for Medicare & Medicare Services (CMS) picked 25 organizations for the next stage of its AI challenge including IBM, Booz Allen Hamilton and Mayo Clinic.

Fierce Healthcare

Thursday, October 31, 2019

Hospitals Take Shot At Opioid Makers Over Cost Of Treating Uninsured For Addiction

While thousands of cities and counties have banded together to sue opioid makers and distributors in a federal court, another group of plaintiffs has started to sue on their own: hospitals.

Kaiser Health News

Tuesday, October 29, 2019

Firms Seeking Top Workers Find They Can't Offer Only High-Deductible Health Plans

Everything old is new again. As open enrollment gets underway for next year's job-based health insurance coverage, some employees are seeing traditional plans offered alongside or instead of the plans with sky-high deductibles that may have been their only choice in the past.

NPR

Tuesday, October 29, 2019

Uber lands EHR deal with Cerner

Uber Health is now available on Cerner's EHR platform, allowing U.S. providers and Cerner clients to schedule non-emergency medical transportation for their patients in the ride-hailing giant's first EHR integration.

Healthcare Dive

Monday, October 28, 2019

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday
Oct252019

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

Pharma Sells States On ‘Netflix Model’ To Wipe Out Hep C. But At What Price?

When a long, black bus bearing the logo of drugmaker AbbVie rolls through Washington state next year, it will promote a new effort to eradicate hepatitis C infections.

Kaiser Health News

Friday, October 25, 2019

Feds owe health insurers $1.6 billion in unpaid subsidies, judge rules

A federal judge this week ordered the federal government to pay about 100 health insurance plans a total $1.6 billion in unpaid subsidies.

Modern Healthcare

Thursday, October 24, 2019

Health system margins rebounded last year but trail 2015 levels

Major U.S. health systems rebounded on their operating margins last year by an average of 13%, but they still average at 30% below 2015 levels, according to a Navigant analysis released Wednesday.

Healthcare Dive

Wednesday, October 23, 2019

Premiums for popular Obamacare plans to drop 4 percent

Premiums for key plans sold on HealthCare.gov will drop by 4 percent on average next year, with several states seeing double-digit declines, the Trump administration said this morning.

Politico

Tuesday, October 22, 2019

UPS flies further into healthcare with CVS, AmerisourceBergen, provider partnerships

UPS Flight Forward, the logistics provider's drone subsidiary, has sealed partnerships with CVS Pharmacy, AmerisourceBergen, Kaiser Permanente and the University of Utah Health System to deliver healthcare supplies via drone.

Healthcare Dive

Tuesday, October 22, 2019

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

 

Friday
Oct182019

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

 

Google nabs ex-Obama official DeSalvo for new chief health role

Google has hired ex-Obama administration official Karen DeSalvo as its first chief health officer, further solidifying its investment in the $3.5 trillion industry by rounding out its healthcare team.

Healthcare Dive

Friday, October 18, 2019

Whistleblower Alleges Medicare Fraud At Iconic Seattle-Based Health Plan

Group Health Cooperative in Seattle, one of the nation’s oldest and most respected nonprofit health insurance plans, is accused of bilking Medicare out of millions of dollars in a federal whistleblower case.

Kaiser Health News

Friday, October 18, 2019

Surprise Settlement In Sutter Health Antitrust Case

Sutter Health has reached a tentative settlement agreement in a closely watched antitrust case brought by self-funded employers, and later joined by the California Attorney General’s Office.

Kaiser Health News

Thursday, October 17, 2019

Medicare, Medicaid hospital payment cuts to hit $252.6B, industry study finds

Reductions in federal payments to hospitals will total $252.6 billion from 2010 through 2029, reflecting the cumulative impact of a series of legislative and regulatory actions, according to a new study from Dobson DaVanzo & Associates, a health economics and policy consulting firm.

Healthcare Dive

Wednesday, October 16, 2019

New study: Full-scale 'Medicare for All' costs $32 trillion over 10 years

The study from the Urban Institute and the Commonwealth Fund found $32.01 trillion in new federal revenue would be needed to pay for the plan, highlighting the immense cost of a proposal at the center of the health care debate raging in the presidential race.

The Hill

Wednesday, October 16, 2019

 

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday
Oct112019

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

 

Sutter, Kaiser among hospitals hit by Northern California blackouts

The blackouts created by the Pacific Gas & Electric (PG&E) utility in Northern California have led to numerous hospitals relying on their backup generators for power.

Healthcare Dive

Friday, October 11, 2019

Amazon Textract now HIPAA-eligible as tech giant expands AI portfolio

Amazon Textract, a machine learning service that automatically extracts selected text and data from scanned documents, is now HIPAA-eligible, Amazon Web Services announced in a blog post Thursday.

Healthcare Dive

Friday, October 11, 2019

How HHS wants to update anti-kickback rules to support value-based care

HHS on Wednesday issued long-anticipated proposed rules to update anti-kickback and physician-referral regulations so they do not interfere with physicians' ability to participate in value-based payment arrangements.

The Advisory Board

Thursday, October 10, 2019

VCU Health Will Halt Patient Lawsuits, Boost Aid In Wake Of KHN Investigation

VCU Health, the major Richmond medical system that includes the state’s largest teaching hospital, said it will no longer file lawsuits against its patients, ending a practice that has affected tens of thousands of people over the years.

Kaiser Health News

Wednesday, October 9, 2019

Waste gobbles up 25% of US healthcare spending, JAMA study finds

The estimated cost of waste in the U.S. healthcare system ranges from $760 billion to $935 billion, or about 25% of the total healthcare spending, according to a report in JAMA issued Monday.

Healthcare Dive

Monday, October 7, 2019

 

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

 

Friday
Oct042019

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

 

Why Hospitals Are Getting Into The Housing Business

One patient at Denver Health, the city’s largest safety net hospital, occupied a bed for more than four years — a hospital record of 1,558 days. Another admitted for a hard-to-treat bacterial infection needed eight weeks of at-home IV antibiotics, but had no home.

Kaiser Health News

Friday, October 4, 2019

Humana's chief strategy officer: Insurance giant is shifting to be a healthcare company

Insurance giant Humana operates a mail-order pharmacy, has more than 230 owned or alliance primary care clinics and a large home health care provider, Kindred at Home. And the payer continues to build out capabilities to address members' social determinants of health.

Fierce Healthcare

Thursday, October 3, 2019

Trump signs executive order bolstering MA in pushback on 'Medicare for All'

President Donald Trump signed an executive order in Florida on Thursday he said would bolster the Medicare program as numerous Democratic presidential candidates seek to expand the program beyond seniors, a move Trump said would jeopardize the entire program.

Healthcare Dive

Thursday, October 3, 2019

US vaping illnesses top 1,000; death count is up to 18

The number of vaping-related illnesses has surpassed 1,000, and there’s no sign the outbreak is fading, U.S. health officials said Thursday.

The Associated Press

Thursday, October 3, 2019

Walmart To Give Workers Financial Incentives To Use Higher-Quality Doctors

Worried its employees aren’t getting good enough care from doctors in their insurance networks, Walmart next year will test pointing workers in northwestern Arkansas, central Florida and the Dallas-Fort Worth area toward physicians it has found provide better service.

Kaiser Health News

Thursday, October 3, 2019

 

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

 

Friday
Sep272019

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

 

Vaping-Related Illnesses Climb to 805, C.D.C. Says

The latest weekly tally includes 275 more reports of patients sickened, in 46 states. There are now 12 deaths linked to vaping-related lung injuries.

The New York Times

Friday, September 27, 2019

 

Senate approves delay in planned DSH cuts

The Senate approved a delay in $4 billion in planned cuts to Medicaid disproportionate share hospital (DSH) payments set to go into effect in November.

Fierce Healthcare

Thursday, September 26, 2019

 

Uber And Lyft Ride-Sharing Services Hitch Onto Medicaid

Arizona Medicaid Director Jami Snyder heard many complaints about enrollees missing medical appointments because the transportation provided by the state didn’t show or came too late.

Kaiser Health News

Thursday, September 26, 2019

 

Amazon launches pilot of virtual employee medical service Amazon Care

Amazon is piloting a new virtual health service benefit for employees and their families in the Seattle region. Calling it Amazon Care, the tech giant said the service combines "the best of both virtual and in-person care" by offering virtual visits, in-person primary care visits at patients' homes or offices and prescription delivery.

Fierce Healthcare

Tuesday, September 24, 2019

 

Walmart announces plan to build healthcare workforce, offering education for $1 a day

As Walmart moves deeper into primary care, the retail giant wants to ensure there is a skilled healthcare workforce to fill critical roles in its 20 care clinics.

Fierce Healthcare

Tuesday, September 24, 2019

 

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday
Aug302019

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week: 

They Got Estimates Before Surgery — And A Bill After That Was 50% More

Before scheduling his hernia surgery, Wolfgang Balzer called the hospital, the surgeon and the anesthesiologist to get estimates for how much the procedure would cost. But when his bill came, the estimates he had obtained were wildly off.

Kaiser Health News

Friday, August 30, 2019

Health insurers slam CMS proposal to alter Medicare Advantage audits

Health insurers and their industry trade groups this week urged the federal government to scrap proposed changes to the way it audits Medicare Advantage plans, warning the changes could result in higher costs and reduced benefits for seniors.

Modern Healthcare

Thursday, August 29, 2019

Medicare Part D paid millions for drugs already covered by Part A hospice benefits

Despite a previous warning, the Center for Medicare and Medicaid Services failed to take steps to ensure the Medicare Part D program does not also pay for medicines that should be covered under the Medicare Part A hospice benefit, resulting in an estimated $161 million in duplicate payments in 2016, according to a new federal government analysis.

Stat News

Thursday, August 29, 2019

Administration ends protection for migrant medical care

The Trump administration has eliminated a protection that lets immigrants remain in the country and avoid deportation while they or their relatives receive life-saving medical treatments or endure other hardships, immigration officials said in letters issued to families this month.

AP News

Monday, August 26, 2019

Judge Cites Opioid ‘Menace,’ Awards Oklahoma $572M In Landmark Case

An Oklahoma judge has ruled that drugmaker Johnson & Johnson helped ignite the state’s opioid crisis by deceptively marketing painkillers and must pay $572 million to the state.

Kaiser Health News

Monday, August 26, 2019

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

 

Friday
Aug232019

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week: 

$16B veterans' health project hits major snag

Veterans Affairs Secretary Robert Wilkie insisted last week that the Trump administration is "on track" with a $16 billion project to connect medical records for the military and vets.

Politico

Friday, August 23, 2019 

Dialysis Industry Spends Big To Protect Profits

The dialysis industry spent about $2.5 million in California on lobbying and campaign contributions in the first half of this year in its ongoing battle to thwart regulation, according to a California Healthline analysis of campaign finance reports filed with the state.

Kaiser Health News

Friday, August 23, 2019 

Opioid Treatment Is Used Vastly More in States That Expanded Medicaid

States that expanded Medicaid under the Affordable Care Act have seen a much bigger increase in prescriptions for a medication that treats opioid addiction than states that chose not to expand the program, a new study has found.

NY Times

Thursday, August 22, 2019 

Exclusive: Cigna seeks sale of group benefits insurance business - sources

U.S. health insurer Cigna Corp is exploring a sale of its group benefits insurance business, which could be valued at as much as $6 billion, four people familiar with the matter said on Tuesday.

Reuters

Wednesday, August 21, 2019 

The Collapse Of A Hospital Empire — And Towns Left In The Wreckage

The money was so good in the beginning, and it seemed it might gush forever, right through tiny country hospitals in Missouri, Oklahoma, Tennessee and into the coffers of companies controlled by Jorge A. Perez, his family and business partners.

Kaiser Health News

Tuesday, August 20, 2019 

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

 

Friday
Jul122019

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week: 

‘Cadillac Tax’ on High-Cost Health Plans Could Affect 1 in 5 Employers in 2022

A new KFF analysis estimates that the Affordable Care Act’s tax on high-cost health plans would affect one in five (21%) employers offering health benefits when it takes effect in 2022 unless employers change their health plans.

Kaiser Health News

Friday, July 12, 2019 

Reckitt Benckiser Agrees to Pay $1.4 Billion In Opioid Settlement

British company Reckitt Benckiser has agreed to pay $1.4 billion to resolve all U.S. government investigations and claims in what is the biggest drug industry settlement to date stemming from the nation's deadly opioid epidemic.

NPR

Thursday, July 11, 2019 

As Its Drug Pricing Plans Fall Through, Trump Administration Turns To Congress To Act

The Trump administration has dropped one of the meatiest portions of its plan to reduce drug prices.

NPR

Friday, July 12, 2019 

California Effort to Stop Surprise Hospital Bills Stalls

A California proposal aimed at limiting high medical bills from emergency room visits has stalled for the year.

Associated Press

Thursday, July 11, 2019 

Congress has ambitious agenda tackling health care costs

Lawmakers are trying to set aside their irreconcilable differences over the Obama-era Affordable Care Act and work to reach bipartisan agreement on a more immediate health care issue, lowering costs for people who already have coverage.

Associated Press

Monday, July 8, 2019 

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday
Jun282019

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

Scott Gottlieb walks through the revolving door to the Pfizer board

After a two-year stint running the Food and Drug Administration, Scott Gottlieb has joined the board of directors at Pfizer, giving the world’s largest drug maker crucial insights into the inner workings of the Trump administration as it attempts to contain national angst over the rising cost of medicines.

Stat News

Friday, June 28, 2019

Five Things We Found In The FDA’s Hidden Device Database

After two decades of keeping the public in the dark about millions of medical device malfunctions and injuries, the Food and Drug Administration has published the once hidden database online, revealing 5.7 million incidents publicly for the first time.

Kaiser Health News

Thursday, June 27, 2019

Senate health committee may change surprise billing proposals ahead of floor vote

The Senate health committee approved its major healthcare package on Wednesday, but with one change to the proposed ban on surprise medical billing and potentially more to come ahead of a full Senate vote expected later this month.

Modern Healthcare

Thursday, June 27, 2019

In first 2020 debate, Democrats escalate their attacks on pharma and its high prices

Democrats demonized the pharmaceutical industry throughout the first primary debate of the 2020 presidential election, racing to prove their status as the candidate most willing to “take on pharma.”

Stat News

Thursday, June 27, 2019

At AHIP19, a call to 'break glass' to survive fast-changing industry

A panel of top executives, including a major provider, payer and former CMS chief opened America's Health Insurance Plan's annual meeting with some soul searching and a call for the industry to disrupt itself.

Healthcare Dive

Monday, June 24, 2019

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday
Jun212019

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

 

Surgeons’ Opioid-Prescribing Habits Are Hard To Kick

As opioid addiction and deadly overdoses escalated into an epidemic across the U.S., thousands of surgeons continued to hand out far more pills than needed for postoperative pain relief, according to a KHN-Johns Hopkins analysis of Medicare data.

Kaiser Health News

Friday, June 21, 2019

 

Health Insurance Providers Launch Project Link to Address Social Barriers to Health

Not every health care problem can – or should – be addressed with a prescription pad. That’s why America’s Health Insurance Plans (AHIP) is launching Project Link – a new initiative that brings together the best thinking on how to effectively address social barriers to health and long-term well-being.

AHIP

Thursday, June 20, 2019

 

1 In 6 Insured Hospital Patients Get A Surprise Bill For Out-Of-Network Care

About 1 in 6 Americans were surprised by a medical bill after treatment in a hospital in 2017 despite having insurance, according to a study published Thursday.

Kaiser Health News

Thursday, June 20, 2019

 

Private Medicare Advantage Could Hit 70% Market Share

Enrollment of seniors in private Medicare Advantage plans could reach 70% of those eligible for federal health benefits for the elderly between 2030 and 2040, a new report shows.

Forbes

Tuesday, June 18, 2019

 

Trump says he will roll out new health care plan in next couple of months

President Trump said he'll be rolling out a new health care plan in a couple of months, saying it will be a key focus in his 2020 reelection campaign.

The Hill

Monday, June 17, 2019

 

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday
Jun072019

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

Why Some CEOs Figure ‘Medicare For All’ Is Good For Business 

Walk into a big-box retailer such as Walmart or Michaels and you’re likely to see MCS Industries’ picture frames, decorative mirrors or kitschy wall décor.

Kaiser Health News

Friday, June 7, 2019

U.S. Records 1,000th Case of Measles, Officials Blame Misinformation for Outbreak

The United States has recorded 1,001 measles cases so far this year in the worst outbreak of the highly contagious disease in more than a quarter-century, federal health officials said on Wednesday as they issued a new plea for parents to vaccinate their children.

NY Times

Thursday, June 6, 2019

Growing Hack of Health-Care Data Gets Scrutiny From Congress

A hack of health-care data involving a medical bill collector and two major diagnostics companies has grown to almost 20 million people, and is now attracting more questions from key members of Congress.

Bloomberg

Thursday, June 6, 2019

CVS to expand health hubs to 1,500 stores by end of 2021

CVS Health Corp said it would offer expanded health services such as nutrition counseling and blood pressure screenings in 1,500 stores by the end of 2021, following through on plans announced during the pharmacy chain’s 2018 acquisition of health insurer Aetna.

Reuters

Wednesday, June 5, 2019

Supreme Court rules against Obama-era provision on Medicare reimbursements 

The Supreme Court on Monday ruled that an Obama-era rule change on how Medicare reimbursements to hospitals are made should be removed because officials did not follow the proper notice and comment regulations in implementing the formula.

The Hill

Tuesday, June 4, 2019

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday
May242019

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

House leaders propose restructuring Medicare Part D

U.S. House of Representatives health committee leaders have drafted new reforms to Medicare Part D as Congress prepares for a final legislative sprint on drug pricing.

Modern Healthcare

Friday, May 24, 2019

Bipartisan senators reveal sweeping health care package

A sweeping draft legislative package from the bipartisan leaders of the Senate Health Committee seeks to lower health care costs by addressing surprise medical bills and adding transparency to drug prices, among other provisions.

The Hill

Friday, May 24, 2019

CBO: Medicare for All gives 'many more' coverage but 'potentially disruptive'

Experts from Congress’s nonpartisan budget office testified Wednesday that a single-payer health care system would result in “many more” people with health insurance but would also be “potentially disruptive” and increase government control.

The Hill

Thursday, May 23, 2019

Measles outbreak spreads to 24 states

The number of measles cases in the United States climbed again this week, bringing the number to 880 cases across 24 states, according to the Centers for Disease Control and Prevention (CDC).

The Hill

Tuesday, May 21, 2019

Poll: Many Rural Americans Struggle with Financial Insecurity, Access To Health Care

Polling by NPR finds that while rural Americans are mostly satisfied with life, there is a strong undercurrent of financial insecurity that can create very serious problems for many people living in rural communities.

NPR

Tuesday, May 21, 2019

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday
May172019

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

As ER Wait Times Grow, More Patients Leave Against Medical Advice

Emergency room patients increasingly leave California hospitals against medical advice, and experts say crowded ERs are likely to blame.

Kaiser Health News

Friday, May 17, 2019

CMS takes aim at spread pricing in Medicaid managed care

The Centers for Medicare & Medicaid Services issued an information bulletin (PDF) on the calculations for a Medicaid managed care plan’s medical loss ratio, as the agency is concerned insurers aren’t accurately including pharmacy benefit manager spread pricing in those calculations.

Fierce Healthcare

Wednesday, May 15, 2019

Will Washington State's New 'Public Option' Plan Reduce Health Care Costs? 

Millions of Americans who buy individual health insurance, and don't qualify for a federal subsidy, have been hit with sticker shock in recent years.

NPR

Friday, May 17, 2019

Low-rated US hospitals are deadlier due to mistakes, botched surgery, infections 

Patients' risk of dying from medical mistakes, deadly infections and safety lapses have gotten much worse at the lowest ranked U.S. hospitals, underscoring Americans' need to check ratings of their local hospitals, new research released Wednesday shows.

USA Today

Thursday, May 16, 2019

Walmart Charts New Course By Steering Workers To High-Quality Imaging Centers 

Walmart Inc., the nation’s largest private employer, is worried that too many of its workers are having health conditions misdiagnosed, leading to unnecessary surgery and wasted health spending.

Kaiser Health News

Wednesday, May 15, 2019

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday
May032019

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

Most Americans grateful for their job's health coverage, but still struggle with healthcare costs

Most people with employer-sponsored insurance are generally happy with their health plans, but many still struggle with healthcare affordability, according to a Kaiser Family Foundation/Los Angeles Times survey.

Becker's Hospital Review

Friday, May 3, 2019

Insys’s John Kapoor Is First CEO Convicted of Opioid Racketeering

Insys Therapeutics Inc. founder John Kapoor was convicted of a racketeering conspiracy that drove sales of a highly addictive opioid while contributing to a nationwide epidemic.

Bloomberg

Friday, May 3, 2019

Budget office: Caveats to government-run health system

Congressional budget experts said Wednesday that moving to a government-run health care system like “Medicare for All” could be complicated and potentially disruptive for Americans.

AP News

Thursday, May 2, 2019

Medicaid Work Requirements Hit Roadblocks

Toward the end of 2018, the Trump administration seemed to be marching briskly toward its goal of requiring able-bodied adults in Medicaid to prove they had jobs to participate in the public health plan for the poor.

Pew Trust

Wednesday, May 1, 2019

Officials declare measles outbreak in Pacific Northwest over

A measles outbreak that sickened more than 70 people, mostly children, in the Pacific Northwest is finally over even as the total number of cases nationwide continues to spike to near-record levels, officials said Monday.

AP News

Tuesday, April 30, 2019

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday
Apr052019

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week: 

Average prices higher for outpatient healthcare, study finds

Commercially insured patients face higher prices for a set of healthcare services performed in outpatient settings compared to those at physician offices, according to a Health Care Cost Institute study.

Becker's Hospital Review

Thursday, April 4, 2019 

Insurers, hospitals, physicians united in stance on ACA lawsuit

Hospitals, physicians and insurer groups are united in wanting to preserve the Affordable Care Act and have defended it in briefs filed with the Fifth Circuit Court of Appeals.

Healthcare Finance News

Wednesday, April 3, 2019 

Fixing Surprise Medical Bill Problem Shouldn’t Fall To Consumers, Panel Told

One point drew clear agreement Tuesday during a House subcommittee hearing: When it comes to the problem of surprise medical bills, the solution must protect patients — not demand that they be great negotiators.

Kaiser Health News

Wednesday, April 3, 2019 

CMS, states face difficult choices on Medicaid expansion, work requirements

The Trump administration and many states face a complex set of policy decisions in the wake of a federal judge’s decision vacating Medicaid work requirement waivers in Kentucky and Arkansas.

Modern Healthcare

Tuesday, April 2, 2019 

Association Health Plan Ruling Puts Some Companies in Limbo

A federal judge's ruling against a type of health insurance plan designed for small business owners has some companies now thinking about what to do next.

Associated Press

Tuesday, April 2, 2019 

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday
Mar292019

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week: 

Ruling creates uncertainty for states’ Medicaid work rules

The governor whose state is at the center of the fight over work requirements for Medicaid recipients said Thursday he wants to fight a judge’s ruling blocking those rules, while Republicans elsewhere are trying to determine the decision’s effect on their state.

Seattle Times

Friday, March 29, 2019 

Trump administration suffers another Obamacare blow in court

The Trump administration has lost another Obamacare legal battle — its second this week — just as the president has revived his drive to destroy and replace the 2010 health law.

Politico

Friday, March 29, 2019 

Centene to buy smaller rival WellCare Health Plans in deal worth $17.3 billion

Major U.S. health insurer Centene will purchase government-sponsored health-care provider WellCare Health Plans in a cash and stock deal valued at $17.3 billion.

USA Today

Friday, March 29, 2019 

Medicaid Expansion Boosts Hospital Bottom Lines — And Prices

The Medicaid expansion promoted by the Affordable Care Act was a boon for St. Mary’s Medical Center, the largest hospital in western Colorado. Since 2014, the number of uninsured patients it served dropped by more than half, saving the nonprofit hospital more than $3 million a year.

Kaiser Health News

Wednesday, March 27, 2019 

Purdue Pharma settles with Oklahoma in landmark opioid lawsuit

Purdue Pharma and the state of Oklahoma have agreed to a $270 million settlement in a lawsuit that claims the illegal marketing of OxyContin helped lead to the opioid crisis.

The Hill

Wednesday, March 27, 2019 

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday
Mar222019

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week: 

Government watchdog: Costly air ambulances can put patients at 'financial risk'

Air ambulances can be life-saving for critically ill patients who need to get to a hospital quickly, but they can also put patients in financial risk, according to a study conducted by the Government Accountability Office (GAO).

The Hill

Friday, March 22, 2019 

Health Plans For State Employees Use Medicare's Hammer On Hospital Bills

States. They're just as perplexed as the rest of us over the ever-rising cost of health care premiums.

NPR

Thursday, March 21, 2019 

Fentanyl-Linked Deaths: The U.S. Opioid Epidemic's Third Wave Begins

Men are dying after opioid overdoses at nearly three times the rate of women in the United States. Overdose deaths are increasing faster among black and Latino Americans than among whites. And there's an especially steep rise in the number of young adults ages 25 to 34 whose death certificates include some version of the drug fentanyl.

NPR

Thursday, March 21, 2019

Bayer shares slide after latest Roundup cancer ruling

Shares in Germany’s Bayer’s fell more than 12 percent on Wednesday after a second U.S. jury ruled its Roundup weed killer caused cancer.

Reuters

Wednesday, March 20, 2019 

Ohio accuses UnitedHealth's OptumRx of drug overcharges in lawsuit

Ohio’s attorney general on Monday said he had filed a lawsuit against UnitedHealth Group Inc’s OptumRx unit, saying the pharmacy benefit manager had overcharged the state nearly $16 million for prescription drugs.

Reuters

Tuesday, March 19, 2019 

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday
Mar012019

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week: 

Medicare Trims Payments To 800 Hospitals, Citing Patient Safety Incidents

Eight hundred hospitals will be paid less by Medicare this year because of high rates of infections and patient injuries, federal records show.

Kaiser Health News

Friday, March 1, 2019 

CMS considers tossing hospital star ratings methodology

The CMS is considering scrapping the model it uses to assign hospital star ratings, signaling a big shift from the agency's stance just seven months ago.

Modern Healthcare

Thursday, February 28, 2019 

Did some pharma execs offer misleading testimony to a Senate committee?

During Tuesday’s Senate hearing on drug pricing, each of the seven pharma execs insisted their companies have never withheld samples from generic rivals, a step that has raised concerns about unfairly thwarting competition.

Stat News

Thursday, February 28, 2019 

Anthem Says Bid to Save $49 Billion Deal Was ‘Cut Off at Knees’

Cigna Corp. officials did everything they could to sabotage a $48.9 billion merger with Anthem Inc., including refusing to consider divestitures that would have helped the deal win regulatory approval, Anthem’s general counsel told a judge.

Bloomberg

Tuesday, February 26, 2019 

U.S. Judge Will Not Block Amazon-Berkshire-JPMorgan Health Venture's New Hire

The decision by U.S. District Judge Mark Wolf in Boston came in a lawsuit closely watched in the industry for clues about the future plans of the venture, which was announced in January 2018 with a goal of lowering healthcare costs.

NY Times

Monday, February 25, 2019

 

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.