The future of the Advisory Committee on Immunization Practices (ACIP) remains uncertain following a judge's intervention against changes made by recent appointees to the panel. One of the panel's members took to social media to express his...White Papers, E books, Reports and more
Last week, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) released a duo of issue briefs that illustrate the use of antipsychotic drugs in nursing homes through inappropriate diagnosis practices.
The first issue brief focuses on the use of the drugs as chemical restraints and the second follows up...Available To All
The proposition of Medicare Advantage as a program relies on the assumption that private insurance companies are better situated to control costs and deliver medical coverage than a sprawling government bureaucracy. After nearly a quarter of a century, the results remain unclear, with obvious advantages and disadvantages to both forms of...Arizona Comings & Goings
Banner Health has named Paula Shepherd senior vice president and chief operating officer of Banner Plans and Networks, which serves 1.2 million members across six states.
Shepherd, a 25-year healthcare operations veteran, assumed the role March 16 and will oversee efforts to align insurance operations with coordinated care delivery...CMS Rules
This week, the Centers for Medicare and Medicaid Services (CMS) announced a new payment model that aims to bolster comprehensive health coverage for children with complex medical and behavioral health needs. The Accelerating State Pediatric Innovation Readiness and Effectiveness (ASPIRE) Model is a state-based model that will serve...Arizona News
This week Phoenix Children’s announced it's aligning its statewide primary care network, Phoenix Children’s Pediatrics, under Phoenix Children’s Medical Group, bringing primary care and specialty physicians under a single leadership structure.
As part of the change, Darcey Winterland, MD was named Division Chief of Phoenix...Arizona News
As state legislatures, including Arizona, debate the merits of banning gender transition healthcare services for minors, a federal judge in Oregon ruled that Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. overstepped when he made the declaration that providers of such services "do not meet professionally recognized...
Private equity’s (PE) expanding role in healthcare is drawing renewed scrutiny from policymakers, researchers and market observers, as activity accelerates across hospitals, nursing homes and behavioral health services. In the past decade, PE investors have bet $1 trillion on healthcare. Lawmakers responded this week by introducing...
Arizona is advancing a major overhaul of its Medicaid infrastructure, with new milestones in its AHCCCS MES modernization effort focused on data exchange and program integrity. AHCCCS also plans to roll out a new customer service system next month. The modernization effort is part of a broader initiative to replace legacy systems,...Arizona News
Earlier this month, the Government Accountability Office (GAO) published a report on market concentration of private dental and vision insurers by state. The House Energy committee requested the report to determine how availability affects consumer choice. In 2024, Arizona had 44 dental insurers with Delta Dental claiming the most market...
A Massachusetts judge on Monday temporarily blocked changes to federal vaccine policy made under HHS Secretary Robert F. Kennedy Jr., ruling that recent appointments to the CDC’s vaccine advisory committee are likely invalid under the Federal Advisory Committee Act.
Several medical organizations, including the American Academy of...
Last week, the Centers for Medicare and Medicaid Services released requests for applications (RFAs) for state Medicaid plans and Medicare Part D plans that would be interested in participating in the new Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth (BALANCE) Model which focuses on lowering prices for GLP-1 drugs....
A surprising twist in the war in the Middle East is a cyberattack targeting a Michigan-based durable medical equipment manufacturer, calling into question the country's health information security amid a stark increase in cyberattacks against healthcare infrastructure.
Last week, Stryker, a medical and surgical equipment manufacturer,...
Last Thursday, Microsoft revealed its new medical- and health-based AI offering, Copilot Health. Copilot Health is a feature within the Copilot app that will allow patients to interface with a chatbot designed to dispense personalized healthcare advice based on patient medical records and health data.
Microsoft said at the unveiling...National News
The Medicaid and CHIP Payment and Access Commission (MACPAC) released its annual March Report to Congress on Medicaid and the State Children's Health Insurance Program (CHIP), which focuses on home and community-based services (HCBS) workers and transparency for behavioral healthcare, especially as coverage involves the youth population...White Papers, E books, Reports and more
As states weigh Medicaid eligibility and coverage changes amid tightening budgets, a new Milliman analysis highlights that reducing enrollment does not translate into straightforward savings, particularly in managed care programs.
Facing tighter budgets, and Medicaid funding losses due to the Trump administration's One Big Beautiful...Arizona News
Abrazo West and Abrazo Arrowhead launched “The Nest,” this week, a rebranded and expanded approach to women’s and maternal health services across both campuses, bringing together labor and delivery, neonatal care and postpartum support under a single model.
The Tenet health system said the initiative is designed to provide...Arizona News
The program is aimed at addressing the mental health needs of firefighters, law enforcement officers, EMTs and paramedics.
The program, according to Denova, was developed in response to growing demand for clinicians trained to understand the trauma exposure, shift work and cultural pressures unique to those professions.
Led by...Open
On Tuesday, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) released the results of a report that found improper coding in emergency department procedure codes led to $15 million in improper or potentially improper payments.
The report covered emergency department codes for services provided in 2021...White Papers, E books, Reports and more
The use of AI in medical billing has been criticized for allowing insurance companies more opportunity to issue claims denials and entrench the use of prior authorization in billing. But a new report from the Blue Cross Blue Shield Association (BCBSA) shows that they're not the only side using AI in medical billing to its...National News
The White House has spent the past several weeks shaking up leadership within the Department of Health and Human Services (HHS), responding to criticisms and polling on the public's perception of the vaccine schedule overhaul. But the Make America Healthy Again (MAHA) movement may be too entrenched in the anti-vaccine movement for that...
Eli Lilly is pivoting to employers to sell its GLP-1 agonist weight loss drug Zepbound directly to patients through a new platform that aims to clarify coverage options and lower out-of-pocket costs for employees.
The pharmaceutical giant intends to use the Employer Connect platform to help employers combine medication with services...
Over the past year, the healthcare sector has buoyed the national jobs market even as other workforces experienced exceptional turmoil, healthcare added jobs to an otherwise stagnant workforce. In February, the market stopped being a workforce haven.
Over 28,000 jobs in healthcare were lost in February, the Bureau of Labor Statistics...
The healthcare sector is aggressively incorporating AI into all levels of productivity as products become available to meet the market's niche needs. This week, the Healthcare Information and Management Systems Society (HIMSS) Global Health Conference and Exposition in Las Vegas showcases the breadth of AI capabilities.
Systems that...
In a presentation last week, the Medicaid and CHIP Payment and Access Commission reviewed how states and the federal government monitor Medicaid managed care organizations, which cover about 74% of Medicaid beneficiaries and account for more than half of program spending.
As in Arizona, most Medicaid beneficiaries are now enrolled in...
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