Arizona researchers are encouraging policy makers to enact strict orders in order to curb what may become a catastrophic burden on hospital capacities, but Governor Ducey and members of Congress have not yet heeded those suggestions. Additionally,...Arizona News
Across the country, COVID-19 cases and subsequent hospitalizations are leaving hospitals short-staffed and without enough space to care for patients. In Arizona, in both cities and rural areas, these issues are no different, compounded by winter visitors to the state and general increase in hospitalizations due to seasonal...National News
Amid a pandemic that has caused people to avoid the hospital, health systems and hospitals are suffering financially. According to a Kaufman Hall report released this week, hospital operating margins have declined by 18.7% since the start of this year to the end of October.
The poor margins are driven by declining patient...CMS Rules
Last week, the Centers for Medicare and Medicaid Services (CMS) released a propose rule for 2022 Notice of Benefit and Payment Parameters. The proposed rule would lower the user fee or Affordable Care Act (ACA) insurers to 2.25% of the premium for the coverage year 2022 and also would enable states to partner directly with the private...
A great read from Skilled Nursing News about how skilled nursing facilities can better manage new contracts with multiple payers during the pandemic.
Chad Bogar, the founder and CEO of the law firm sb2 Inc., told Skilled Nursing News that it's critical skilled nursing facilities' (SNFs) contract negotiators sharpen their pencils...
UnitedHealth Group is one of the largest health insurance providers in the country along with Anthem, Humana, Health Care Service Corporation (HCSC) and CVS Health Corp., together they control more than 38% of the American market.
UnitedHealth Group (UHG) cited treatment and testing costs tied to the pandemic. The insurer expects it...CMS Rules
On Tuesday the Centers for Medicare and Medicaid Services (CMS) released the final rule for policy adjustments under the Physician Fee Schedule (PFS) for calendar year 2021. The rule confirmed changes to telehealth payments made during the COVID-19 pandemic, but will make cuts to specialty providers.
Last March, during the onset...
Unemployment insurance may have short-term health effects through at least three pathways, as benefit income can meet health-related social needs (food and housing), cover health care access expenses (insurance premiums, co-pays, transportation), and reduce stress - improving mental health.
During the COVID-19 pandemic, more than 30...
Real estate developer Alter and Banner Health announced plans for a $54 million, three-story, 80,000-square-foot comprehensive sports medicine center at the Riverwalk in Scottsdale, located along the Loop 101 at Indian Bend Road.
Scott Nordlund, Banner's chief strategy and growth officer, said,
This project is a great example of...
Nearing 20 pages, our annual data edition provides readers with an overview of major hospital systems including revenue, employees, 2020 annual highlights, executive leadership, community benefit contributions for non-profits, new hospital construction projects, value-based contracting partners, facility-level data highlights, pandemic...
Senior Connect Acquisition I, a blank check company formed by the founder of UnitedHealth targeting the senior market, filed in late November with the SEC to raise up to $300 million in an initial public offering.
In reporting from Home Health Care News, the special-purpose acquisition company (SPAC) is focusing on senior care,...
In September, the Centers for Medicare and Medicaid Services released the Evaluation Report of the First Three Years (2017-2019) of the Medicare Advantage Value-Based Insurance Design Model Test, conducted by RAND Health Care.
The Value-Based Insurance Design (VBID) allows Medicare Advantage (MA) plans to offer incentives to...CMS Rules
Last Friday, the Centers for Medicare and Medicaid Services announced a final rule that makes changes to the Physician Self-Referral Law, or Stark Law, which prohibits doctors from referring patients to services or providers owned or employed by the referring physician. The law has caused issues for participants in value-based...
In September, NORC at the University of Chicago released its evaluation of the Next Generation ACO's rates of participation among providers and beneficiaries, as well as savings for the Medicare Program. The study looked at 2018, the third participation year for the advanced payment model.
Those participating as a Next Generation...CMS Rules
Last Friday, the Trump administration announced two interim final rules in a last-ditch effort to fulfill the president’s campaign promises of lowering drug prices for seniors. Many of President Trump’s prior efforts were blocked by litigation or lost momentum during the rule making process. With eight weeks left in his presidency,...
As cases hit record highs nationwide and hospitals both local and national warn of looming overcrowding in intensive care units, local hospital officials are speaking out about travel for the holidays and individual responsibility. Meanwhile, there’s been significant progress on treatment and vaccine in the past couple weeks, and...
At the start of the pandemic, 160 million people in America had insurance through their employers. The pandemic’s disruption to the economy resulted in a loss of coverage for an estimated 14.6 million workers and their dependents by June of this year.
Millions who still have employer benefits have lost wages and income, making...
In 2018 and 2019, CMS paved the way for supplemental benefits in MA plans by granting more flexibility for insurers. They have taken advantage.
A recent analysis from Milliman found that the number of Medicare Advantage plans across the country that offered at least one supplemental benefit increased by 64% from 2020 to 2021....
The virtual event was held Nov. 9, recognizes excellence in the medical community- excellence practiced by physicians, administrators and volunteers. Health Care Heroes are selected and judged based on nominations from those in the profession and the business community.
Check out the Phoenix Business Journal Health Care Heroes...
During the third week of the Open Enrollment period, 758,421 people selected plans using the HealthCare.gov platform, about a 3% bump year-over-year; Since Open Enrollment began Nov. 1, Arizona has reported 35,068 plan selections; enrollment weeks are measured Sunday through Saturday.
Open to shoppers in 36 states since November...
Valleywise Community Health Centers in Glendale and El Mirage are scheduled to move in January 2021. The services and most of the care team will transition to the new Valleywise Comprehensive Health Center – Peoria, located at the corner of Grand Avenue and Cotton Crossing.
The new facility located at 8088 W Whitney Drive in...
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Equality Health, a comprehensive value-based care delivery system, is expanding its operations into Texas and partnering with health plans and primary care providers to enable improved cost and quality performance in value-based contracts.
In January, health plan partners in Arizona agreed to contracts that would allow Equality...
This week there’s good news and bad news in Arizona and across the country as COVID-19 positivity rates are on an uptick and experts openly predict a “dark winter”. The Navajo Nation and Pima County are reporting troubling spikes as ICU bed use steadily increases statewide. But new treatments are slowly becoming available and the...
About 818,000 shoppers selected individual health insurance on HealthCare.gov the first week of the Open Enrollment Period (OEP) that began November 1.
Of the shoppers selecting plans this week (OE8) about 645,000 were renewing coverage and about 173,000 were new to the Marketplace. Below is a year-over-year comparison of open...
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