Repealing and replacing the Affordable Care Act (ACA) has been central to the GOP crusade on healthcare since President Trump's election in 2016. He promised to overhaul the legislation and completely reform America's healthcare system right way,...Arizona News
The Next Generation ACO saved CMS $4.8 million and achieved a 98% quality score.
Arizona Care Network (ACN) attributes its 2018 results to its physician-led model, focus on the long-term wellness of the patients served by the network, investment in cutting-edge technologies and transformation of its population health model. Interim CEO...Arizona News
Arizona's Medicare Advantage market continues to climb with a 38 percent saturation rate; latest numbers following the annual enrollment period shows UnitedHealthcare's AARP branded product still reigns supreme.
According to data from the Centers for Medicare & Medicaid Services, UnitedHealthcare/Pacificare's AARP plan reprised...
After rebranding the MSSP to the Pathways to Savings in 2018, CMS reported about 11.2 million Medicare beneficiaries are now served by 517 ACOs participating in the shared savings program, and 200 are taking downside risk.
Only 35 new ACOs joined the revamped Medicare Shared Savings Program (MSSP) in 2020, far below the annual...
The Trump Administration’s recent push to tighten Medicaid eligibility is drawing national criticism. As the administration considers more frequent eligibility reviews, state Medicaid agencies are under increasing pressure to control costs and meeting new federal requirements is expensive.
Centers for Medicare and Medicaid Services...
This week the American Journal of Managed Care published an article regarding the ways in which the healthcare market affects primary care physicians, and the diversity of ways in which people access primary care.
The retail health consumer approach, influenced by the commodification of healthcare in the United States by health...
About 8.3 million Americans signed up or were re-enrolled in plans on HealthCare.gov during the 2020 open enrollment period (OEP), down about 5% year-over-year.
Arizona stayed on trend with a 5% enrollment decrease as only 153,020 residents selected or were automatically re-enrolled through the HealthCare.gov platform by the end...
Startup insurer Bright Health recently announced plans to acquire California-based Brand New Day health plan, a move that demonstrates interest in the Medicare Advantage market and launches them into the Golden State, a new territory for the payer.
Just last month, Bright Health made public a $635 million Series D funding round...
Former Blue Cross Blue Shield Association (BCBSA) Chief Medical Officer Dr. Trent Haywood has launched a new venture that guides healthcare startups in navigating the healthcare system for easier implementation in the marketplace.
Haywood established Knowality in November 2019, a venture services firm that provides product...
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Last year, Mayo Clinic conducted a study of all staff physicians employed by the Mayo Clinic in Minnesota, Arizona and Florida in clinical roles in order to assess the equity of pay in specific demographic categories. The study found that across campuses, the Mayo Clinic has an estimation of what pay equity should look like.
A...
The family of an incapacitated woman, who gave birth in December 2018 under the care of Hacienda Healthcare facility, is suing the state of Arizona and her two former doctors for negligence.
Filed on Dec. 24 in Maricopa County Superior Court, the suit lists the 30-year-old woman along with her parents as plaintiffs. No dollar...
Banner Health employees reached a proposed settlement of $500,000 following allegations that the Phoenix-based health system breached its duties under the 1974 Employee Retirement Income Security Act (ERISA).
Plaintiffs in the case, Ramos v. Banner Health, allege Jeffrey Solcum & Associates, the investment consultant...
A study recently published by JAMA Surgery set out to evaluate the health outcomes of Medicare beneficiaries who have undergone emergency general surgery (EGS). The study’s central question was: How does this population fare compared to those with acute medical conditions, like pneumonia, heart failure, and acute myocardial...CMS Rules
CMS wants to increase the amount of encounter data the agency uses to calculate Medicare Advantage (MA) risk scores from 50% to 75%; final 2021 MA payment rates are expected on or before April 6.
Even as the industry continues to express concern over the reliability of encounter data, The HCC Risk Adjustment Model is now driven by...
Another Health Affairs study found no evidence of reduced spending or quality improvement for other bundled clinical episodes.
One Health Affairs study, "The Impact Of Bundled Payment On Health Care Spending, Utilization, And Quality: A Systematic Review," included a systematic review and impact of the Acute Care Episode...
If the US Supreme Court agrees to hear the case during its current session, it could make its decision before the 2020 presidential election.
We’re asking the Supreme Court to swiftly resolve this repeal lawsuit for the sake of saving lives and ending uncertainty in our healthcare system.
The pressure follows the ruling by the...
Mark Carroll M.D. accepted the position in the New Year; he was formerly the chief health officer for The NARBHA Institute, which was formerly the Northern Arizona Regional Behavioral Health Authority.
During his three years at NARBHA, Dr. Carroll also served as a member of Health Choice Generation’s Medicare Advisory...
In addition to Steward Health Choice individual and employer plans, BCBSAZ will now provide health coverage and related services to Arizonans eligible for Arizona Health Care Cost Containment System (AHCCCS) Complete Care plan and the “Generations” Medicare health plan.
Pam Kehaly, President and CEO of...
A study published in JAMA Network Open last month found children enrolled in Medicaid who live in communities with a population health management program could experience far fewer hospital admissions and bed-days in hospitals per year.
The study sought to investigate a specific aspect of a shift in dependent health coverage across...
OptumCare Arizona has opened another community center geared toward older adults aged 55 and over in Central Phoenix, near 12th St. and Glendale Ave.
The facility will have a fitness center and offer a variety of classes, including Tai Chi, Pilates, knitting, line dancing, zumba, quilting and other arts and crafts, as well as...
The manufacturer of a potent fentanyl spray, Subsys, appears to be shutting down operations after filing for bankruptcy last summer and years of litigation.
Insys Therapeutics agreed to vacate its Chandler headquarters by Dec. 31, 2019 and according to bankruptcy filings, any property belonging to debtors that remain after Dec. 31...
A new bill presented to the Arizona Legislature would require healthcare providers who object to certain services on religious grounds to clearly identify themselves.
In 2012, with the backing of the influential conservative lobbying organization, Center for Arizona Policy (CAP), the state passed a law that prohibits the...
After failing to agree on a contract, most Cigna customers in California won't find Dignity's hospitals, outpatient surgery centers and medical groups in their provider directory as of January 1, 2020.
Cigna ended another Dignity Health contract Dec. 1 in Nevada citing the system was overpriced for the region - an argument it...
Banner Health is finally paying up after a June 2016 cyberattack; the health system agreed to a $6 million settlement last month. The security incident was said to have impacted 3.7 million people and turned into a class-action suit in 2017 after 11 individually filed suits.
The settlement includes free insurance coverage for...
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