News

Alaska governor bucks lawmakers to expand Medicaid

Alaska Gov. Bill Walker, a Republican turned Independent who has unilaterally decided to expand Medicaid eligibility on his own. Walker will apply to the Centers for Medicare & Medicaid Services (CMS) directly, bypassing the Legislature, which has blocked expansion repeatedly, the New York Times has reported.

Barnabas, Robert Wood Johnson merger will create giant system in New Jersey

Two large healthcare systems in New Jersey have announced their final plans to merge, creating a mega-system that would be by far the Garden State's largest provider.

Hospitals will have to engage in major expense reduction for financial success

Despite relatively dramatic growth in hospital spending over the past year and the expansion of health insurance coverage to millions of Americans as a result of the Affordable Care Act, acute care facilities still struggle with eroding margins.

South Carolina Hospital Association launches pricing website

The South Carolina Hospital Association has launched a price transparency website for consumers, and prices range widely for a variety of procedures.

Louisiana's University Health files antitrust suit against competitor

Shreveport, Louisiana-based University Health System this week filed a federal lawsuit accusing its competitor, Willis-Knighton Medical Center, of violating federal antitrust laws in its agreement with Louisiana State University.

Medicaid at 50: A program mired in controversy

As the agency celebrates the 50th anniversary of the Medicaid program, the program is mired in controversies such as cost overruns and bitter politics, according to USA Today

North Carolina hospitals sue over DSH payments

Seven North Carolina providers are suing the federal government over the Affordable Care Act's cuts to disproportionate share hospital payments, according to the Triad Business Journal.

More hospitals launch ERs tailored to older patients

A significant number of hospitals across the United States are opening up special emergency rooms for elderly patients, the Columbus Dispatch has reported.

HHS wants to improve nursing home, long-term hospital care

The U.S. Department of Health and Human Services has made a sweeping range of proposals intended to improve the safety and functioning of the 15,000 or so long-term care hospitals (LTCH) and nursing homes that operate in the United States.

Providers, payers collaborate to tame rising drug costs

The current dynamics of healthcare delivery is prompting the pharmaceutical industry to more closely collaborative with providers and insurers to develop products that deliver better value to patients, according to a new study by the PwC's Health Research Institute entitled "21st Century Pharmaceutical Collaboration: The Value Convergence."

The pros and cons of Certificate of Need repeal

A move is underway in at least two states to repeal or revisit certificate of need (CON) laws, which regulate healthcare expansion. The law prohibits providers from entering new markets or expanding their organizations without the approval of state regulators. Opponents say the regulations hurt competition. But proponents claim a repeal could reduce or eliminate certain services, limiting patient access to care.

Puerto Rico could lose billions in Medicare, Medicaid payments

Puerto Rico, which already is in the midst of a financial crisis, is facing steep cuts in Medicare Advantage rates and a likely lapse in funds supplementing its Medicaid programs, according to the Washington Post.

Healthcare prices remain in low growth mode

New data from the Altarum Institute shows overall prices grew by just 1.1 percent in May 2015 compared to May a year ago. Hospital prices grew by 0.7 percent during that same period and were essentially flat for both Medicare and Medicaid patients.

Hospital costs for giving birth can vary by a factor of 10

You can determine the sex of your child well before he or she is born, but when it comes to figuring how much that birth will cost, all bets are off. That's the conclusion of a study published in the most recent edition of the journal Health Affairs.

CMS to transform hip and knee replacement payment model

Medicare will now pay providers who perform hip and knee replacement surgeries based on their ability to deliver high-quality, low-cost care under a five-year initiative announced Thursday by the federal government. 

Iora Primary Care's unconventional relationship to payments

Iora Primary Care has a unique approach toward fee-for-service payments: it does not accept them at all.

GAO: Remove financial incentives from 340B program

A new Government Accountability Office report recommends that the Centers for Medicare & Medicaid Services curtail the financial incentives offered to safety-net hospitals that participate in the 340B drug discount program.

California rehab hospital sues HHS over backlogged appeals for denied claims

The Casa Colina Hospital and Centers for Healthcare in Pomona, California, has filed a suit against the U.S. Department of Health and Human Services, claiming its backlogged process for resolving Medicare payment disputes has removed sorely needed revenue from its coffers.

Medicare proposes to pay doctors for end-of-life discussions with patients

The proposed 2016 Medicare Physician Fee Schedule released this week includes a plan to pay physicians that have end-of-life conversations with their patients.

How post-King v. Burwell merger mania will affect hospitals

Hospitals are ideally positioned to withstand consolidation in the health insurance industry, according to a report from Fitch Ratings.