In a competitive field, UnitedHealthcare Pacificare (AARP) retains its lead following the Medicare Advantage open enrollment period that closed December 7, 2018 for the 2019 plan year.
CMS released January 2019 enrollments - MA enrollment in...Top of The Day
The agency's Center for Medicare and Medicaid Innovation (CMMI) announced updates to the Value-Based Insurance Design (VBID) Model along with a brand new Part D Payment Modernization Model.
The VIBD model was launched in 2017, the update announced last Friday is designed to further reduce Medicare costs, enhance the quality of care...Top of The Day
On Friday, January 18, The Arizona Health Care Cost Containment System (AHCCCS) received 1115 Waiver Amendment approval from the Centers for Medicare and Medicaid Services (CMS) to begin implementing work requirements next year - the move is predicted to impact about 120,000 able bodied AHCCCS members ages 19 to 49; beginning April 2019...Top of The Day
Critics say the quick turnaround for applications after the program's recent overhaul to greater risk is cause for concern and are advocating CMS extend its application window and push back the deadline.
The National Association of ACOs (NAACOS) and America's Physician Groups (APG) both complain ACOs are still responding to the...Top of The Day
Pima Community Access Program (PCAP) helped low-income community members in Southern and Southeastern Arizona access quality, affordable health insurance options; all PCAP inquiries are now forwarded to the El Rio Health Center's outreach and enrollment department.
The not-for-profit organization provided access to professional...Top of The Day
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...Top of The Day
Arizona's Medicaid agency will be led by Snyder beginning Jan. 4. She succeeds the retiring Tom Betlach, the longest serving AHCCCS director in the state's history.
Serving as deputy director of the Arizona Health Care Cost Containment System (AHCCCS) since December of 2017, Snyder isn't new public service, nor to Arizona. She...Top of The Day
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...Top of The Day
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,...Top of The Day
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...Top of The Day
MDIG now has an agreement to provide sub-specialty diagnostic, vascular and interventional radiology services to three Steward hospitals in the state: Luke's Behavioral Health Center, St. Luke's Medical Center, and Mountain Vista Medical Center.
Effective December 1st, 2018MDIG will be the exclusive professional radiology services...Top of The Day
The public squabble has lasted nearly a year, but now the two have agreed to extend their nationwide contract effective January 1, 2019.
UnitedHealthcare (UHC) has threatened for months to end its contract with Envision Healthcare. Envision fired the first shot this spring and missed its target when it was forced into arbitration...Top of The Day
The ink is barely dry on its $69 billion merger with Aetna and now CVS drops the news on its new Guaranteed Net Cost pricing model designed to simplify the financial arrangements underlying PBM contracts. CVS said it can deliver savings through PBM cost management strategies such as formulary, utilization management and performance...Top of The Day
Mark Dewane will now chair the five-member board that oversees Maricopa Integrated Health System (MIHS), which includes Maricopa Medical Center, McDowell Healthcare Center, the Refugee Women’s Health Clinic, the Arizona Children’s Center, two behavioral health centers, and a dozen neighborhood Family Health Centers.
Chairman...Top of The Day
One of the nation's pharmacy giants merges with one of the biggest health insurers with a vision of improving healthcare.
When announcing the deal on Wednesday, CVS Health President and CEO Larry Merlo said,
Today marks the start of a new day in health care and a transformative moment for our company and our industry. By delivering...Top of The Day
The Department of Homeland Security announced the proposal of a “public charge” in September that if enacted, would authorize the government to issue penalties to immigrants using federal programs such as Medicare or Medicaid funded through taxpayer-dollars.
A “public charge” assesses the likeliness of an immigrant being...Top of The Day
The statewide, multiyear agreement impacts about 2,000 physicians in Arizona practicing at Banner Health, Dignity Health and HonorHealth hospitals.
While Envision clinicians will be in-network for Cigna’s commercial, Medicare and individual plan customers in Arizona, UnitedHealthcare and Envision are facing a termination of their...Top of The Day
A local and national leader on managed Medicaid and healthcare policy, Betlach spent nearly two decades with the Arizona Health Care Cost Containment System (AHCCCS), Arizona's Medicaid agency; Betlach served nine years as AHCCCS director and eight as its deputy director.
Governor Doug Ducey announced Betlach's retirement today,...
City of Hope and Translational Genomics Research Institute (TGen) announced plans to form an alliance earlier this week to develop a cell therapy manufacturing facility in Phoenix. California-based City of Hope is branching out from its California roots with multiple facilities in Duarte, California.
As an independent cancer...