Many companies in 2018 sought a slice of the healthcare pie, including e-commerce titan Amazon, resulting in a massive conglomerate deal with J.P. Morgan Chase and Berkshire Hathaway. Tech-giant Apple began to carve its own path in the industry and...National News
Always available upon request, prices for procedures are now posted online to encourage patients to exercise their healthcare literacy to make market decisions - first lesson: it's not what you'll pay.
Because the list price isn't what price your insurance company pays, critics say CMS' new rule may not be effective when it comes to...National News
In a Dec. 20 letter to CMS Administrator Seema Verma, the national insurance advocacy group, American Health Insurance Plans (AHIP), said pass through funding should not be available to subsidize the purchase of alternatives to individual market health insurance, including short-term limited duration insurance.
AHIP was providing...National News
U.S. District Court Judge Reed O'Conner hasn't budged from his view that the ACA is unconstitutional, but issued a stay Dec. 30 allowing the law to stand while his controversial decision is taken up on appeal.
Arizona is one of 20 GOP-led states that brought the case in Texas arguing the ACA's individual mandate is inseverable from...National News
A study by the American Journal of Medical Care (AJMC) highlighted the hospital grades the Centers for Medicare and Medicaid Services (CMS) posted on Hospital Compare for heart failure (HF) and acute myocardial infarction (AMI) readmissions are inconsistent with the scores used to set penalties under the Hospitals Readmissions Reduction...National News
Venture to downtown Phoenix and in the heart of the city on Van Buren St. and Central Ave., right next to Civic Space Park, anyone can see the homeless problem in Phoenix. Park benches and the local transit station is littered with people who do not have anywhere else to sleep. A new program, Street Medicine Phoenix, aims to provide...National News
In collaboration with PolitiFact, ProPublica published a story last week revealing longer wait times for veterans and higher costs for taxpayers as a result of Veterans Choice, a private medical care program for veterans.
The U.S. Department of Veteran Affairs (VA) has long been a topic of controversy, a fully-government operated...National News
Blue Cross Blue Shield of Arizona (BCBSAZ) and Phoenix Children's Hospital (PCH) will be continuing their provider relationship with a new three-year contract. The initial contract deadline was extended to make room for negotiations, but an agreement was reached.
PCH will continue to be part of the provider network for BCBSAZ...National News
A report by CBRE, commercial real estate and investment firm, reveals the number of outpatient facilities are on the rise, with a 51 percent increase from 2005 to 2016. The firm's research identifies a surge in mergers and acquisitions (M&A) as a cause of lower-cost outpatient centers.
The absorption rate in areas such as...National News
The agency released Part 1 of the 2020 Advance Notice on Dec. 19; The Centers for Medicare & Medicaid Services (CMS) is proposing to include additional patient conditions when calculating risk adjustment payments for Medicare Advantage (MA) plans.
CMS also proposes to adjust its risk score calculation by boosting the weight of...National News
The merger creating a new company called CommonSpirit Health won't close before the New Year as expected. The merger will create a system with a fleet of 140 hospitals (five in Arizona) operating across 16 states.
CommonSpirit Health would also include 700 care sites and employ 159,000 employees and about 25,000 physicians and other...National News
In the new "Pathways to Success" model, ACOs will have to be ready to take financial risk sooner.
The final policy reduces the amount of time new ACOs can stay in the program without taking risk from six to two years and just one year for existing one-sided ACOs. The agency made one exception to its fast track initiative: new,...National News
There may be more health plan choices in individual markets, but narrow networks are squeezing enrollees when it comes to physician choice. An Avalere analysis found that narrow network plans make up almost 75 percent of the exchange market, which means restricted choices when it comes to doctors and hospitals within a health plan's list...National News
The Centers for Medicare and Medicaid Services (CMS) still has $1.6 billion to collect in Medicaid overpayments, news revealed through Office of Inspector General (OIG) audits. A new December OIG report explains that CMS's timely recovery of overpayments helps to confirm that federal funds are being used effectively and...National News
If successful, the merger would create one of the largest urgent care providers in the country with 251 clinics across 10 states; FastMed now has 110 clinics (31 in Arizona) and NextCare operates 141 urgent care facilities (42 in Arizona).
In its clinics, FastMed offers a range of acute/episodic and preventive healthcare services,...National News
Health Affairs cites a report that analyzed 2010 MA vs. fee-for services Medicare claims data showing MA is between 9 and 30 percent lower than Traditional Medicare for healthcare spending per enrollee, per month.
In a future study out of Stanford University by Vilsa Curto and colleagues, the researchers write,
We calculate that MA...National News
A November Office of Inspector General (OIG) report found that 46 percent of Medicare patients in Long-term-care hospitals (LTCH) experienced some type of harm during care. The OIG examined other post-acute settings such as skilled nursing facilities (SNFs) and rehabilitation centers, but LTCHs had the highest overall...National News
A federal judge in Fort Worth, Texas ruled the Affordable Care Act (ACA) unconstitutional on Friday, leaving those enrolled in the ACA uncertain in terms of the law's future. No changes will be made to the 2010 act that is still law as appeals are being filed, the case does have the possibility of reaching the U.S. Supreme...National News
Providers, employers and consumer groups have unified to fight surprise billing and lobby Congress into passing legislation that would ultimately protect patients from receiving surprise medical bills from out-of-network providers.
These bills are most commonly issued to patients who may have visited an emergency department that does...National News
Efforts by Kansas and Louisiana, two Republican-led states, seeking to defund Medicaid funding for organizations offering women’s reproductive health services, such as abortions, was thwarted when the U.S. Supreme Court refused to hear the case in a 6 to 3 decision.
The two states attempted to block Medicaid funding for...