The Hertel Report

Healthcare Industry Puts Blockchain to the Test as Initial Hype Subsides

Since its resurgence in popularity a few years ago, blockchain's capabilities have been applied across various industries to see how the digital ledger can impact businesses globally. In healthcare, organizations have noted opportunities in...

Banner Health Acquires Phoenix Orthopaedic Consultants

Four orthopedic surgeons and one certified nurse practitioner joined Banner Health's medical group Dec. 2. Providers joining Banner Health include: Marc Rosen, MD Kishore Tipirneni, MD Jonathan Landsman, MD Stephen Ripple, MD Leslie Johnson, FNP-C Clinicians will soon practice out of two office locations in the...

CMS Rules

CMS’ Updates to the Medicare Plan Finder Backfire

For the first time in the last decade, the Centers for Medicare and Medicaid Services (CMS) updated the popular health plan shopping tool Medicare Plan Finder, but the recent redesign initiative has raised concerns for consumer advocacy groups that say the tool offers inaccurate information. The federal government spent $11 million...

NAACOS Commissioned Report: MSSP ACOs Saved CMS $3.53B From 2013-2017

The report's authors also estimated net savings of $755M after accounting for shared savings payments made by the Centers for Medicare & Medicaid Services (CMS). The Washington, D.C.-based consulting firm Dobson DaVanzo & Associates was hired to produce the independent evaluation, the latest in a series, by the National...

Health Insurance Marketplace - Week 5

More than a half million Americans signed up during the week of Nov. 24-30 pushing plan selections to about 2.9 million; in Arizona, 42,385 consumers in the state have chosen a health plan on HealthCare.gov since open enrollment began Nov. 1. The open enrollment period lasts through December 15, 2019. Last year in the final week of...

Magellan Rx Management Summer Email Breach - Impact Broadens

The subsidiary of Scottsdale-based Magellan Health learned July 5 about unauthorized access to a employee email that included PHI belonging to members of Presbyterian Health Plan (PHP) in New Mexico and McLaren Health Plan in Michigan. This week Health IT Security is reporting Magellan Health added Michigan-based McLaren Health to...

AHCCCS Embraces SDOH With New Whole Person Care Initiative

AHCCCS has announced its new, social determinants of health (SDOH) focused Whole Person Care Initiative. The program is a collaboration with Arizona’s Health Information Exchange (HIE) to develop systems that screen for risk factors and refer beneficiaries to community resources equipped to address them. AHCCCS describes the...

Maricopa County Special Health Care District Board Elects its Leaders

The Maricopa County Special Health Care District Board of Directors has elected Mark Dewane and Mary Rose Wilcox to leadership positions. The board oversees Valleywise Health, the safety net health system with a 140 year history in the Phoenix area. Dewane, with nearly 35 years of experience in the finance field, was re-elected and...

Ensign Purchases Mesa's Mission Palms Post Acute

Ensign Group's Arizona-based subsidiary, Bandera Healthcare had its eye on acquiring a skilled nursing facility (SNF)  in Mesa; the December deal was announced alongside the news that Ensign had acquired the operations of four SNFs in Dallas. Ensign acquired the real estate and operations of Mission Palms Post Acute, a skilled...

Marketing to the Person Not the Disease - MM&M Video

In this video, Miriam Paramore, president and chief strategy officer of OptimizeRx, underscores the value that personalized messaging brings to the patient and to the healthcare provider. When developing messaging, it’s important to think of the patient as a person, of which the patient journey is just one part. Develop...

US Radiology Specialists Partner with Tucson's Radiology Ltd.

Radiology Ltd. is the largest private practice radiology group and outpatient imaging operator in Tucson; more evidence of the rapid expansion of US Radiology Specialists. Radiology Ltd. is a team of 40 radiologists and the group provides 24-hour coverage for Tucson Medical Center and St. Joseph's Hospital. In addition, its...

Banner-University Medical Center Phoenix Hires New CEO

Daniel Post, the former regional executive VP of strategy and business development at Loyola Medicine in Illinois, begins his role Jan. 27 succeeding Steve Narang, MD, who left Arizona's largest health system for the role of Inova Fairfax Medical Campus President earlier this year. According to Banner Health, Post has more than 30...

UnitedHealthcare to Open Medicare Centers in Select Walgreens Locations - Including Phoenix

Walgreens and UnitedHealthcare have entered in an agreement to open 14 Medicare service centers starting next year, which will allow customers to inquire about and enroll in UnitedHealthcare Medicare Advantage plans. For existing UnitedHealthcare MA beneficiaries, the centers will serve as a place to schedule appointments, such as...

Issue Brief - The Value of Medicare & Medicaid Alignment

This first brief in the series by the Center for Health Care Strategies (CHCS) and The Advancing States highlights the value of integrated care for state Medicaid agencies from published research and anecdotal information from state leaders who have launched these programs. "The Value of Pursuing Medicare-Medicaid Integration for...

Most SNF's Aren't Expecting Value-Based Payment Shifts in 2020

Long-term and post-acute care providers, including skilled nursing facilities (SNFs) are unable to implement the Centers for Medicare and Medicaid Services (CMS) value-based payment model without more advanced IT and technology support, according to a survey. The survey of 1,640 long-term and post-acute care providers led by Black...

U of A College of Medicine Initiative: Addressing the PCP Shortage by Paying Tuition

The University of Arizona Colleges of Medicine in Tucson and Phoenix is offering to cover medical school tuition for those who commit to practice primary care in underserved regions of the state for at least two years following their residency. An American Medical Association (AMA) study published in the summer linked increasing...

GAO Prods CMS to Curb Nursing Home Abuse - Again

A new Government Accountability Office (GAO) report calls out the Centers for Medicare & Medicaid Services (CMS) for failing to comply with recommendations issued in another, recent GAO report on nursing home abuse.  The original report, released in July 2019, stated that nursing home abuse cases had doubled between 2013 and...

Employer Groups Express Hospital Pricing Woes

Hospital prices continue to be scrutinized as employer groups deem costs way too high and pressure from the Trump Administration to publish negotiated prices increases. According to a Rand report, significant discrepancies were found between what private health plans pay for hospital services versus Medicare, highlighting that...

CDC Report Lays Out Disturbing Details of Antibiotic Resistant Threats

Last week, the Centers for Disease Control released a striking report on antibiotic resistant threats. It claims that nearly 3 million such infections occur yearly in the US causing 35,000 deaths. This represents a 52% increase from the death toll stated in their previous report, published in 2013.  Almost half of those lives...

Potential CMS Star Rating Methodology Changes Raises Concerns

As the Centers for Medicare and Medicaid Services (CMS) considers possible changes to the methodology it uses to calculate hospital star ratings, some experts are worried the proposed adjustments do not adequately account for patient needs. The agency announced in August plans to update the quality measurement methodology of the...

Phoenix Children’s Hospital Hires New Pediatric Cardiac Surgeon

Phoenix Children’s Hospital has added a highly touted heart surgeon to their staff.  Roosevelt Bryant III, MD, will serve has the the surgical director for PCH’s Cardiac Transplantation and Mechanical Assist Device Program. According to the hospital’s press release, Dr. Bryant is “one of the country's foremost pediatric...

CMS Rules

Value-Based Purchasing and the Decline in Hospital Readmission Rates

A new analysis of the decline in hospital readmission rates suggests ties to a drop in hospital admissions all together, rather than a Centers for Medicare and Medicaid Services (CMS) value-based purchasing program as previously credited. The Medicare Hospital Readmissions Reduction Program (HRRP) is a value-based purchasing...

CMS Rules

Hospital Price Transparency - Final Rule

The final rule provides details on the requirements for making public discounted cash prices, payer-specific negotiated charges and de-identified minimum and maximum negotiated charges for at least 300 ‘shoppable’ services, publicly available in a consumer-friendly format effective January 1, 2021. The Health & Human Services...

Mayo Operating Income Reportedly Rose 52 Percent YOY

Unaudited financial statements show that the Rochester, Minn.-based Mayo Clinic, which has a booming Arizona footprint, had higher revenue and net income in the first nine months of 2019 compared to the same reporting period last year. Inpatient hospital and surgical patient volumes drove up revenue during the first three quarters of...

Hacienda Doctor Concedes License

The Hacienda Healthcare physician responsible for performing regular exams on an incapacitated patient, whose rape was only brought to light after unexpectedly giving birth to a baby boy in December, has surrendered his medical license. According to a Nov. 8 consent order from the Arizona Medical Board, Dr. Phillip Gear...