On Tuesday, the Consumer Financial Protection Bureau (CFPB) issued a new rule that would ban credit reports from factoring medical debt into consumer credit scores. The rule is the latest in the Biden administration's efforts to alleviate the...Top of The Day
The American Hospital Association, which represents the interests of hospitals, published its annual report on the latest data and trends in the healthcare field and The Office of Inspector General takes issue with the costs of swing beds in the country's critical access hospitals.
The AHA's report, 2025 Environmental Scan, covers the...National Reports & Surveys
During COVID-19, rules constricting the use of telehealth were waived, opening doors for enrollees in Medicaid to receive behavioral health services through such technology. As a result, providers rapidly shifted their services to focus on telehealth availability, which may have unintended consequences for certain populations.
The...National News
The first U.S. death from avian flu has been recorded in Louisiana, as the country braces for another outbreak and concerns grow about cross-infections in human hosts.
The bird flu, H5N1, is responsible for the death of an individual over the age of 65 who had underlying medical conditions in Louisiana. The case was first reported...Arizona News
The Arizona Department of Health Services (ADHS) has launched a new tool that will make it easier for Arizonans to search through public health data.
The Public Health Data Portal puts "all the agency's data in one place," according to an ADHS news release. The portal includes an easy-to-use interface and a number of tools that should...Top of The Day
The large employer advocacy group Business Group on Health has published seven calls to action for the healthcare industry and employers to take up in order to accelerate the adoption of value-based care models, which is expected to improve patient care and lower costs across the board.
The group notes that adoption of the payment...
The incoming Trump administration and the GOP-controlled 119th Congress likely have designs for healthcare policy that may not become clear until they happen. Industry stakeholders and patients advocates are raising their concerns and hopes for the next two years of lawmaking.
The 119th Congress commences on Friday and will have a...
As President-elect Donald Trump's election looms, hospitals and industry advocates are left wondering what will happen to one of the last rules implemented by his first administration: the hospital price transparency rule.
The first Trump administration's rule required hospitals to post coherent pricing information online. Still, it's...National News
Are low payment rates the reason physicians don't take Medicaid payments? MACPAC seeks to answer that question in MACPACs first issue brief of the new year.
Medicaid physician payment rates are increasingly gaining the attention of lawmakers, so when MACPAC advises Congress on Medicaid and CHIP policy, it's worthy of attention....
The Centers for Medicare & Medicaid Services (CMS) is reporting another record year for ACA plans with 23.6 million consumers across the country choosing a 2025 health plan during the Marketplace Open Enrollment Period (OEP); nearly 3.2 million new shoppers have already chosen a plan and there's still time, the OEP ends January 15,...
Arizona's Medicaid agency expects to help incarcerated individuals coordinate healthcare services upon reentry into the community to improve coordinated access to healthcare care services, improve health outcomes, and reduce recidivism.
To qualify for services, individuals must reside in a correctional facility and determined eligible...Arizona News
Several state Medicaid directors recently indicated that mid-year rate adjustments will help address concerns raised by Medicaid managed care plans about rising costs. These concerns stem from managing beneficiaries with higher acuity and increased healthcare utilization following the unwinding process.
At the November NAMD...
Medicare Advantage insurers are still defrauding the Medicare program by inflating patient diagnostic codes. This week, one company settles with the federal government and another gets found out.
New York Medicare Advantage (MA) insurer Independent Health Corporation and it's (now defunct) subsidiary DxID ended their 12 year legal...
On the way out the door, the Biden administration's Department of Health and Human Services (HHS) launched a campaign to combat misinformation and increase childhood vaccine uptake as President-elect Donald Trump's anti-vaccine allies are poised to take over.
The campaign, Let's Get Real, is designed to "cut through the noise" of...
This week, an editorial from JAMA Network explores the challenges of disentangling the cost shifting between Medicare and the Veteran's Affairs (VA) system as more MA members use VA healthcare services.
The Veteran's Affairs health system is vast and supports nearly 10 million enrollees with a wide array of facilities and specialized...
Perinatal mental health conditions are one of the leading causes of maternal mortality, or death within a year of pregnancy in Arizona.
The Arizona Center for Investigative Reporting found that prenatal mental health screenings are an effective tool for early intervention into pregnancy-related and postpartum depression, but Arizona...National News
After disruption from President-elect Donald Trump and his close advisor and businessman Elon Musk, the U.S. House of Representatives passed a debt ceiling measure that included an extension of some health programs and a continuing resolution to keep the government open until March 14, but dropped provisions that would have regulated...
President-elect Donald Trump's cabinet nominations are proceeding with little Republican pushback as Secretary of Health and Human Services (HHS) nominee Robert F. Kennedy, Jr. (RFK) spent the week visiting the offices of friendly Republican senators. Solicitor general nominee John Sauer and Centers for Medicare and Medicaid Services...News
End-of-year presentations by The Medicare Payment Advisory Commission (MedPAC) provide readers data and analysis of 2023 payments and future 2025 payments for outpatient dialysis, hospice, home healthcare, inpatient rehabilitation, skilled nursing, hospital outpatient billing, rural emergency hospitals and physician and other health...
Rising consumer healthcare costs and increasing commercial reimbursement rates, impacts of the IRA, along with MSSP & REACH ACO shadow bundles and MA agent compensation data - if you can measure it, Milliman had an article, news brief or white paper on it in 2023; we're highlighting a few of our newsroom favorites.
Milliman is a...
This data edition offers a critical snapshot of Arizona’s hospitals and health systems, providing key insights into financial performance, market footprints, and quality ratings that are shaping the future of care in the state.
In this exclusive data edition, members of The Hertel Report will find comprehensive data on hospital...
Healthcare was barely mentioned during the 2024 election cycle, but there are major policy decisions to be made early next year that will have major impacts across the industry.
While Medicaid was almost never mentioned, there are glaring vulnerabilities to the program as President-elect Donald Trump threatens severe cuts to federal...
The Centers for Medicare and Medicaid Services (CMS) launched its nursing home staffing campaign to support compliance with the nursing home staffing minimum rule. The support includes new websites designed to facilitate recruitment and education for new nurses.
The websites aren't a provision of the staffing mandate but an additional...
The costs were also unprecedented for the CMS Innovation Center's models, driven primarily due to risk score growth and prescription drug costs that could not be contained by policy modifications.
The costs are "substantial and unmitigable," exceeding $2.3 billion in 2021 and $2.2 billion in 2022, according to the CMS Blog post on...
The Steward Health Care debacle has drawn public focus to the participation of private equity (PE) in health care. As PE seeks to raise value for shareholders as quickly as possible by any means, it can have calamitous effects on crucial services and the communities that rely on them.
In short, private equity firm Cerberus Capital...
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