This afternoon at the State Medicaid Advisory Committee’s (SMAC) quarterly meeting, AHCCCS Director Tom Betlach briefly announced the resignation of Beth Kohler, Deputy Director of Arizona's Medicaid program.
“I think you all know that...Arizona News
Sale is subject to regulatory approvals and closing conditions, but is expected to close during the fourth quarter of 2017.
St. Louis based Express Scripts provides integrated pharmacy benefit management (PBM) services and has acquired the privately-held eviCore healthcare, which manages medical benefits for 100 million patients....
Approximately 18,000 UHC-Community Plan (UHC-C) members are attributed to Equality Health Network (EHN) primary care providers (PCPs). The PCPs will continue to receive payment based on their existing UHC-C agreements. EHN and UHC-C have an accountable care model agreement that tracks quality measures and per member, per month...
The longtime managed care executive replaces Carolyn Pace, who recently retired; Hoffman was previously the VP of managed care and business development for Phoenix Children's Hospital
Both Carolyn Pace and Ethel Hoffman are Advisors to The Hertel Report.
Management layers between its hospitals and corporate offices are expected to dissolve in hopes of cutting expenses for the hospital chain amidst the growing volume of investors calling for reorganization after Tenet reported a $56 million operating loss in its second quarter following declining hospital admissions.
As the nation's...Arizona News
Rep. Kyrsten Sinema (D-Ariz.) represents Arizona's 9th District, but by moving into the race for a U.S. House seat, Arizona Mayor Greg Stanton is expected to throw his hat into the Congressional race to win Sinema's former House seat.
Sinema announced her intentions to get into the 2018 race on YouTube
According to The...
Managed care organizations (MCOs) are prepping for new seven-year ALTCS contracts starting October 1; Bridgeway is out, Banner University Family Care is in.
In March 2017, the Arizona Health Care Cost Containment System (AHCCCS) awarded contracts to three managed care organizations (MCOs) to provide Arizona Long Term Care Services to...
The Hertel Report members honored last week include Linda Hunt, CEO of Dignity Health in Arizona, who was recognized with the lifetime achievement award; and Dave Berg, Founder and CEO of Redirect Health, who won for innovator of the year.
The annual breakfast, hosted by PBJ Publisher Ray Schey and Editor-in-Chief Illona Lowery,...Arizona News
CMS proposal could decrease hospital revenue, hospital officials say
Orthopedic surgeons and ambulatory surgery centers (ASCs) are excited by a new proposal by the Centers for Medicare and Medicaid Services (CMS) to pay for joint replacement surgeries performed in an outpatient setting.
CMS announced in mid-July that it was...Arizona News
Mayo Clinic Hospital in Phoenix cracks the top 20 nationally for first time.
For the second year in a row, Mayo Clinic Rochester topped the best hospital rankings list by U.S. News and World Report. For the first time, an Arizona hospital makes the top 20 on the national list, called the "honor roll". That hospital? Mayo Clinic...
Tweeted by President Trump on Wednesday, August 9, the sentiment contrasts with a bipartisan effort to fix the Affordable Care Act.
Health and Human Services Secretary Tom Price also had pointed comments to Congress on Wednesday,
"Both folks in the House and the Senate, on both sides of the aisle frankly, have said that Obamacare...
The public comment period ended August 7, 2017; advocacy groups made a last-ditch effort to plead their case on behalf of patients.
More than 75 consumer advocacy groups spoke out to save an Obama-era rule allowing patients to sue nursing homes over neglect, sexual assault, or abuse.
The Centers for Medicare and Medicaid Services...Arizona News
Appellate Court decision allows states to defend ACA's cost-sharing reductions.
A Washington, D.C. appellate court ruled that state's attorneys general have legal standing to sue to receive the Affordable Care Act's cost-sharing reduction subsidies.
The decision adds some clarity and relief to state-level officials as President...Arizona News
MGMA members can view this comprehensive overview of 2018 proposed rule changes to MIPS/APMs and physician fee schedules
This policy analysis by MGMA explains the intricacies of 2018 proposed rules for MIPS/APMs and physician fee schedules.
The 2018 proposed rule revises three central tenets of the MIPS/APM programs:
Scottsdale-based healthcare marketing and public relations firm sees opportunity in Tennessee.
Activate Health’s client roster includes Dignity Health, Avella Specialty Pharmacy, NurseGrid, Arizona Care Network and SpringBoard Healthcare. Activate also has experience launching health information technologies including mobile apps,...Arizona News
Slashing Medicaid could lead to hospital closures in Arizona
Under the Senate replacement bill for the Affordable Care Act (ACA), rural hospitals in Arizona face potentially drastic Medicaid cuts that would increase debt and potentially send some hospitals out of business, leaving thousands of rural Arizonans without a hospital...
How much do Medicaid beneficiaries really like the care they are receiving?
The Centers of Medicare & Medicaid Services (CMS) develops and conducts Consumer Assessment of Healthcare Providers & Systems (CAHPS) surveys to better understand Medicaid beneficiaries’ experiences with providers. These CMS surveys are not measuring...
A fresh and complete look on the impact upcoming healthcare reforms will have on Arizona’s budget, people and economy.
Recent legislation passed by Congress is dramatically cutting federal funds, putting hundreds of thousands of Arizonans at risk of losing Medicaid coverage and could impact the federal budget by billions in the...Arizona News
Blue Cross Blue Shield of Arizona and Centene have filed their intent to offer individual products in 2018 with the Arizona Department of Insurance
CMS released its updated county-level map of 2018 projections on July 5, 2017.
This is yet another failing report card for the Exchanges. The American people have fewer insurance...Arizona News
The insurer, which launched an MAPD product in Colorado last year, is led by former UnitedHealth executive Bob Sheehy.
The new start-up insurance company Bright Health is entering the Arizona marketplace in 2018 in collaboration with Arizona Care Network (ACN). Marketing of MA plans begins October...