Arizona's Medicaid agency took comments on the proposed merger and transition plan of Arizona Complete Health (Centene) and Care1st Health Plan (WellCare) that will result in one insurer - Centene expanding its AHCCCS Complete Care (ACC) market...National News
Last Friday, President Donald Trump signed an executive order vowing to “protect and improve” Medicare through a series of reforms to Medicare Advantage (MA). For the more than half million Arizonans enrolled in a Medicare Advantage plan, this means new procedures may be covered and premiums may be lowered by spurring competition...National News
Many see an increased focus on social determinants of health (SDOH) as a promising strategy to a more efficient and effective healthcare system. But the first step is better data.
The Centers for Medicare and Medicaid Services (CMS) announced it is considering releasing potentially enlightening SDOH data they’ve collected as a part...Arizona News
Special expert appointed by U.S. District Judge Roslyn Silver to review Arizona prison healthcare submitted a report on Oct. 4 recommending the state to steer clear of privatizing inmate healthcare and recommended that Silver instead override a state law requiring Arizona to contract healthcare for prisons from third parties. Following...
Take a look at this resource from America's Health Insurance Plans, a reminder that prescription drug reform often point to these many familiar names featured daily on television screens across the country.
Note: July 2018 Prices
...National News
President Trump issued a proclamation on Oct. 4 barring soon-to-be immigrants from permanent residency in the U.S. within 30 days of entering if they cannot prove they are covered by an approved insurance plan or are unable to pay for healthcare. Effective Nov. 3, the rule includes parents and legal guardians of U.S....Arizona News
More than 40 Arizona hospitals were penalized for the number of patients who return for a second stay within 30 days; poor performance in CMS' Hospital Reduction Program resulted in the highest penalty (3%) for Canyon Vista Medical Center in Sierra Vista and Arizona Specialty Hospitals in Chandler.
The Hospital Readmissions Reduction...
The facility in South Phoenix is expected to open in late 2020 and will provide a range of preventive and primary care services .
Steve Purves, president and CEO of Valleywise Health
“This new Community Health Center will provide access to high quality and compassionate medical services. It also will help to fuel the south...
Bayless Integrated Healthcare will open its third new clinic of the year in the North Phoenix suburb on Oct. 23.
Like its other facilities, the Moon Valley clinic is home to nurse practitioners, therapists, and physicians who supply comprehensive treatment including, family medicine, emotional and behavioral health and virtual...
The National Institutes of Health awarded a $3.6 million grant to the pair of University of Arizona researchers, Andrew Karellas and Srinivasan Vedantham.Both grant recipients are professors in the school’s department of medical imaging. They will use the money to continue to fine tune 3D-imaging technology designed to provide less...
Abrazo Health opened the facility, which is smaller than the company’s existing valley-area facilities and is designed to maximize convenience and efficiency.
Despite its smaller size, the micro-hospital features surgical, diagnostic, and laboratory offerings similar to its full-sized counterparts. The so called “neighborhood”...
On Oct. 1, the Tampa, Florida based WellCare Health Plans announced a $250,000 donation to the Arizona nonprofit organization, Kids Aid.
The funds suport a new integrated health clinic in Prescott. The facility, expected to open January 2020, will be operated by Spectrum Healthcare group whose providers focus on “whole-person...
On September 30, the Centers for Medicare and Medicaid Services announced a test program designed to investigate the effectiveness of health-contingent wellness programs in state insurance markets.
States that want to apply to be one of the ten chosen for the demonstration must provide projected impact analysis and data regarding the...
The U.S. Department of Justice (DOJ) cracked down on 35 individuals found to be tampering with genetic testing reimbursements in a fraudulent Medicare billing scheme totaling $2.1 billion. The defendants were linked to various telemedicine and telemarketing companies as well as cancer genetic testing labs for their participation in the...
A quick reference guide for the Arizona MA market mix. See at a glance the market saturation of MA insurers and where to find MA, MA SNPS or both.
Get The Market Mix
...
The pilot program digitally connects care management teams with Humana Medicare Advantage members and their families, so that members with medical and functional challenges can maintain their independence and receive support at home.
Humana At Home is a division of Humana that identifies and supports Humana Medicare Advantage members...Arizona News
Arizona currently ranks 44th in the nation for access and affordability according to the Commonwealth Fund, which also found that our state is among the lowest ranked in terms of employee insurance costs as a share of median income.
Employer provided insurance plans are rapidly becoming far too expensive for both employers and...Arizona News
October 1 marked the start of the shopping season for Medicare beneficiaries seeking to compare Medicare Advantage (MA) plans prior to purchase during open enrollment October 15 through December 7, 2019.
More than a dozen insurers are offering more than 100 plans in Arizona and every eligible shopper in the state can access a 2020 MA...
The upgraded Medicare Plan Finder was launched August 27 to much fanfare from the Center for Medicare and Medicaid Services (CMS), but attention is now turning to the growing concerns from senior advocacy groups and stakeholders about the platform's functionality.
These issues could spell difficulties for Medicare Advantage (MA)...News
A damaging report by the Arizona Auditor General found that ADHS’s incompetence in responding to complaints against their long-term care facilities could be endangering patients.
The report reviewed 33 complaints filed against five “judgmentally selected” skilled nursing facilities (SNFs) in 2017 and 2018. They found that 14 of...
Walmart's Sam's Club launches healthcare initiative to lower cost of care for its members and increase accessibility. The pilot program, Sam’s Club Care Accelerator Together, is a joint effort with insurance-giant Humana and will be available in three states starting in October.
Members of Sam's Club in Michigan, Pennsylvania...
The Centers for Medicare and Medicaid Services (CMS) published a notice on Thursday informing hospitals of its plans to survey facilities to collect information on their acquisition costs for certain covered outpatient drugs included in the 340B Drug Discount Program.
The notice follows a July proposed rule from the Trump...Arizona News
In 2018, more than 200,000 Arizona Medicare beneficiaries received care through 13 Accountable Care Organizations (ACOs), which in turn reported total savings of nearly $41.5 million.
Recent CMS 2018 performance results report nearly half of Arizona ACOs collected shared savings totaling more than $25 million. Quality scores ranged...
Get the latest on how hospitals fought site neutral payments and won, the DSH cuts delay, the importance of Medicaid's NEMT benefits in Arizona and what's troubling Medicare advocates about CMS' 2020 MA marketing and communication guidelines. Also included are key healthcare positions of leading Democratic contenders for the U.S....
House Speaker Nancy Pelosi's, D-Calif wish list includes directives to HHS to annually negotiate prices "on as many as possible" of the 250 most expensive drugs to Medicare that don't have at least two competitors, the creation of an international price index and escalating penalties for drug manufacturers that refuse to participate in...
The Hertel Report
