KHN: Is CMS Doing Enough to Prevent MA Overpayments?

Last week, Kaiser Health News (KHN) won a lawsuit with the Centers of Medicare and Medicaid Services (CMS) to compel the agency to release 90 federal audits of Medicare Advantage (MA) plans from the years 2011 through 2013. The information contained in these audits demonstrates that overpayments have consistently been made to...

After Nearly a Decade No Drop in Psychotropic Drug Use in Nursing Homes, OIG Reveals

Despite the Centers for Medicare and Medicaid Services’ (CMS) efforts to reduce the amount of psychotropic drugs in nursing homes, rates remained “constant” between 2011 and 2019.  A new report from the Department of Health and Human Services (HHS) Office of Inspector General (OIG) found 80% of Medicare's long-stay nursing home...
Arizona News

The Leapfrog Group's 2022 Fall Hospital Safety Grades - Arizona A List

Earning the highest grade "A" are Arizona hospitals Banner Ironwood, Kingman Regional, Mayo Clinic, Northwest Medical Center, and Shea Medical Center. The national nonprofit watchdog organization that advances patient safety in hospitals, released the fall 2022 Leapfrog Hospital Safety Grade results on November 16, 2022. The...
REPORT: APMs Increasing Market Share, Enthusiasm Rising Among Payers

REPORT: APMs Increasing Market Share, Enthusiasm Rising Among Payers

Last week, the Health Care Payment Learning and Action Network (LAN) published its 2022 Methodology and Results report, which is the result of a data collection survey of health plans and states for an account of how money moves through alternative payment models and how these programs function in terms of barriers and access. In...

"Accountable Care" Gets a Definition Update, VillageMD Acquires Summit Health

This week, accountable care has a new definition following the Health Care Payment Learning and Action Network (LAN) Summit, and the Centers for Medicare and Medicaid Services (CMS) look to get more Affordable Care Act (ACA) plans into value-based insurance design. Out with the old, in with the new. LAN received feedback from...

2022 Midterm Results Prompt Lobbyists to Push Reforms During Lame Duck

The 2022 Midterm Elections have concluded, and while election officials in Arizona continue to tally votes, health industry stakeholders and lobbying officials are already set to work boosting their issues and setting sights on the end-of-the-year budget reconciliation in Congress. In Arizona, Senate Republicans have selected a new...
AHA: Critical Access Hospitals Lost Average of $507,000 From 340B Cuts

AHA: Critical Access Hospitals Lost Average of $507,000 From 340B Cuts

The American Hospital Association (AHA) ran a survey of 300 hospitals and health systems to determine the overall impact of cuts made to the 340B prescription drug pricing program. It found an enormous financial impact on struggling hospitals, specifically those in rural and underserved areas. The 340B drug pricing program requires...

Abortion Update: GA Strikes Down Ban, KY Debates Bans, AZ Seeks to Harmonize Bans

President Joe Biden announced on Monday that the returns in the 2022 Midterm Election would not provide support that Congressional Democrats would need to pass legislation codifying abortion protections into federal law. Republicans have taken control in the U.S. House of Representatives by a slight majority, and while Democrats have...

Report: Medicaid Beneficiaries Show Low Awareness of Resumption of Renewals Post PHE

The Urban Institute reports its analysis of the June 2022 Health Reform Monitoring Survey finding that 62% of adults with family Medicaid enrollment had heard nothing at all about Medicaid renewals resuming creating a significant information gap among enrollees about the change once the PHE ends, which is now likely to be extended to...

Banner Health Hospital News: Visitor Restrictions Due to Flu & RSV Increase

RSV, a seasonal respiratory virus common among young children, has arrived earlier than normal in Arizona with cases up more than 300% compared to a typical season. Effective November 14, the restrictions are designed to help ensure patient and team member safety. Joan Ivaska, senior director of infection prevention at Banner...

CMS Announces Plan to Address Health Equity Data Collection

When the largest payer defines health equity, people listen, but convincing clinical and policy leaders to develop strategies and make changes requires data, lots of it. The Centers of Medicare and Medicaid Services' (CMS) plan focuses on addressing inadequate sociodemographic and social determinants of health (SDOH) data because...

Clover Health to Leave ACO REACH, Insuretech Companies Struggle in Difficult Market

Insuretech companies have suffered some huge financial losses this year, as a result some of them are pulling away from certain Medicare markets and pivoting to other methods of improving business. For the third quarter of 2022, Clover Health posted a $75.3 million net loss, but doubled its total revenue year-over-year from $427...
Page 1 of 232123...
© The Hertel Report 2017. All rights reserved. | Privacy Policy