The non-profit health system plans to assume full operational ownership of Florence Hospital, Mountain Vista Medical Center in Mesa, Steward Mesa Hospital, and St. Luke's Behavioral Health Hospital in Tempe. HonorHealth intends to retain Steward...
On September 8, 2024, The Arizona Health Care Cost Containment System (AHCCCS) dismissed the recommendation of an administrative law judge and denied the appeal of Mercy Care, Health Choice Arizona and Banner-University Family Care after all three local non-profits contested the agency's award of its Arizona Long Term Care EPD contracts...
The contradictions between the goals of Medicare Advantage plans and healthcare providers are becoming increasingly apparent, posing challenges equally for providers and payers.
Medicare Advantage places unique burdens on all provider types from hospitals to private practices. The central issue lies in the use of prior authorization,...
The 2024 Deloitte Health Care Consumer Survey, the research center's 12th since 2008, confirmed the gender healthcare equity gap is widening, with women disproportionately affected.
The analysis concluded women require an average of 9.9% more healthcare services than men—even excluding maternity-related healthcare expenses—due...
Court ordered assisted outpatient treatment (AOT) for people with a serious mental illness (SMI) improved a range of patient outcomes, including appointment and medication adherence, symptomology, perceived mental health, life satisfaction, and therapeutic alliance. This outcome evaluation report from ASPE also found AOT patients reduced...
The Centers for Medicare & Medicaid Services (CMS) and WPS Health Solutions (WPS) recently notified nearly a million Americans about a significant data breach last summer involving protected health information (PHI) and personally identifiable information (PII) related to Medicare services.
Between 2018 and 2023, hacking incidents...
In this annual data edition, The Hertel Report delivers the latest insights on plan enrollment, including detailed membership by county. But this year’s data goes beyond the numbers, revealing alarmingly poor performance among plans serving AHCCCS members across the state. This edition also covers the latest on the ALTCS contract award...
The 2024-2029 Arizona Cancer Control Plan (AzCCP) builds on previous strategies that focus on reducing cancer incidents and mortality in Arizona. The plan incorporates new cancer-related issues and addresses disparities and cancer impact across different Arizona geographic areas, focusing on systematic, environmental, and socioeconomic...
The federal government has issued additional warnings that international ransomware groups are targeting American medical infrastructure to exploit vulnerabilities and disrupt American business for financial gain. But regulations and enforcement around how cybersecurity should be implemented by healthcare entities may fall short of what...
The American Academy of Actuaries (AAA) published an issue brief on the trends and influences that could affect health insurance premiums in 2025. The AAA found that premiums are unlikely to spike but will continue to rise due to higher prescription drug costs and inflation.
The issue brief was developed by the Academy's Individual...
In a win for hospitals and providers, the U.S. Department of Health and Human Services (HHS) withdrew its appeal to a ruling that found the department acted in error when it issued guidance inhibiting providers from using web tracking technologies, or cookies, on their website.
The HHS guidance was issued by the Office of Civil Rights...
Steward Health Care has recently made strides in addressing its financial challenges by reaching an agreement in principle with its landlord Medical Properties Trust Inc. (MPT). The agreement aims to resolve billions of dollars in lease obligations, offering a potential path to keep most of its hospitals operational. MPT has agreed to...
Health insurance coverage is crucial to ensuring young children and their parents have access to affordable, quality healthcare and economic security. American families with young children face distinctive healthcare risks with the highest infant and maternal mortality rates among all high-income countries, according to an Urban...
Recent data underscores a growing crisis in U.S. rural maternity care, driven by inadequate payment structures and significant workforce challenges. Over half (57%) of rural hospitals no longer offer labor and delivery services, and those that continue to provide these services are at risk of closure due to severe financial...
On Tuesday, August 20, U.S. District Judge Ada Brown in Dallas struck down the nationwide noncompete ruling by the U.S. Federal Trade Commission (FTC) set to take effect September 4. The U.S. Chamber of Commerce and the Texas-based tax firm Ryan LLC, which brought the lawsuit, warned the rule would retroactively invalidate millions of...
Recent studies and legislative developments indicate significant healthcare changes with potential Medicare coverage for anti-obesity medications (AOMs). The latest analysis, published on August 15, 2024, sheds light on the financial implications and benefits of incorporating a AOMs into Medicare coverage.
Benedic Ippolito, a senior...
Steward Health Care (SHC), the Texas-based owner of St. Luke’s Behavioral Health Center, announced the furlough of over 200 employees, effective Monday. While these employees will not receive pay during the furlough, they can use paid leave/PTO and will retain full healthcare coverage through the end of next month, according to...
Arizona Spine and Joint Hospital in Mesa is part of the Surgery Partners team: more than 12,000 employees and 4,600 affiliated physicians, serving more than 600,000 patients annually. The ASC chain went public in 2015 with private equity giant Bain Capital being the largest shareholder; industry analysts are predicting profits of $63...
The Arizona Association of Community Health Centers (AACHC)/Arizona Alliance for Community Health Centers (Cover Arizona) received the statewide grant to helping underserved communities, consumers, and small businesses find and enroll in quality, affordable health coverage through Healthcare.gov
In 2021 Navigators working in Maricopa...
The Center for Healthcare Quality & Payment Reform (CHQPR) offers steps to support its contention that value-based payment is only successful when explicitly designed to support value-based care, which the CMS Innovation Center says requires increased data sharing and the AMA warns is only possible when health systems/plans and...
Recent data from the Commonwealth Fund argues the U.S. healthcare system is failing women. What are the statistics and what can be done to change them?
U.S. women’s access to affordable healthcare and life expectancy rates are extremely low compared to other countries across the globe, with extreme ethnic disparities among different...
The Mental Health Parity and Addiction Equity Act is a critical federal safeguard, ensuring Americans do not face greater challenges in accessing behavioral health services than they do for other medical care. Enforcing this law presents complexities, leading to inconsistent compliance among health insurers.
While federal law mandates...
A recently published Milliman white paper discusses how the Inflation Reduction Act (IRA) will alter government funding for Medicare Part D in 2025, including increased Part D direct subsidies (DS) and benefit redesigns.
The 2025 average direct subsidy will increase to $142.67 per member per month, marking the highest level...
The Issue brief defines prior authorization and how this process used by Medicaid fee-for-service programs and managed care organizations (MCOs) requires approval before providing specific items, services, or medications.
Prior authorization (PA) aims to prevent unnecessary utilization, limit improper, fraudulent, and wasteful...
A recent report highlights the disproportional high expenditures on U.S. healthcare and how America stacks up to comparable wealthy countries. The U.S. spent approximately $12,742 per person, whereas Switzerland, the second-highest spender, allocated $9,044 per capita. With the U.S. excluded, the average for comparable counties was...
CMS Rules
