Newsfeed

Bipartisan Senate Bill Would Reform Medicare Primary Doc Pay

A bipartisan bill would tell the Centers for Medicare and Medicaid Services (CMS) to establish hybrid payments to reward primary care providers in the Medicare fee-for-service (FFS) program who provide the best care to their patients, including reducing patients’ emergency visits, hospitalizations, excess specialist services, and other big cost drivers.

Additional article: https://insidehealthpolicy.com/daily-news/whitehouse-cassidy-unveil-primary-care-payment-reform-related-rfi

(Some articles may require a subscription.)

#primarycare #medicare

https://www.fiercehealthcare.com/providers/senators-both-sides-aisle-propose-primary-care-payment-reform-seek-industry-feedback

Read More »

Broussard To Step Down As Humana CEO

Bruce Broussard will step down as CEO of Humana on July 1 and be succeeded by Jim Rechtin, who came in as President and COO. Despite some challenges right now financially, he deserves tremendous credit for building a stellar MA business over a decade plus at the helm.  He tripled enrollment. Broussard will serve as a strategic advisor through 2026.

Additional articles: https://www.fiercehealthcare.com/payers/jim-rechtin-step-humana-ceo-role-july-1 and https://www.modernhealthcare.com/insurance/humana-jim-rechtin-bruce-broussard-ceo

(Some articles may require a subscription.)

#medicareadvantage #humana #broussard

https://www.healthcaredive.com/news/humana-ceo-transition-timeline-broussard-rechtin/716014

Read More »

Kaiser Reports Good Financial News

Kaiser Permanente reported $935 million of operating income (3.4% operating margin) and more than $2.7 billion of net income. This beats Q1 2023 dramatically. Kaiser is also looking to sell off up to $3.5 billion of its investment stakes.

Additional articles: https://www.modernhealthcare.com/finance/kaiser-permanente-investments-wsj and https://www.beckershospitalreview.com/finance/kaiser-posts-935m-operating-profit-in-q1.html

(Some articles may require a subscription.) 

#kaiserpermanente #healthplans #hospitals

https://www.fiercehealthcare.com/finance/kaiser-permanente-posts-34-operating-margin-billions-net-income-q1-2024

Read More »

DOJ Sets Up Antitrust Task Force

The U.S. Department of Justice (DOJ) has set up a multi-disciplinary task force to examine healthcare monopolies and collusion. It will facilitate policy advocacy, investigations, and civil and criminal enforcement.

#antitrust #mergers #acquisitions #manda

https://www.fiercehealthcare.com/providers/justice-department-unveils-task-force-healthcare-antitrust-issues

Read More »

CHS Sues MultiPlan Arguing Conspiracy With Health Plans To Fix Commercial Rates

Hospital giant Community Health Systems has filed a lawsuit arguing the data analytics firm MultiPlan has conspired with health plans to fix commercial rates in violation of antitrust rules. Visit my blog on the controversy: https://www.healthcarelabyrinth.com/out-of-network-provider-billing-is-yet-another-provider-attack-issue-against-plans/

(Article may require a subscription.)

#antitrust #healthplans #providers

https://www.modernhealthcare.com/legal/community-health-systems-chs-multiplan-lawsuit

Read More »

Possible Cyberattack At Ascension

Catholic hospital system Ascension may have been a victim of a major cyberattack.  It runs 139 hospitals and 40 senior living facilities across the country.

Additional article: https://www.modernhealthcare.com/cybersecurity/ascension-possible-data-breach-cyberattack

(Some articles may require a subscription.)

#cyberattacks

https://www.fiercehealthcare.com/providers/systems-clinical-operations-interrupted-ascension-amid-apparent-cybersecurity-event

Read More »

Telehealth and Hospital At Home Extensions Coming

The House Ways and Means Committee may pass a 2-year extension of telehealth as well as a 5-year extension of hospital at home. It would be paid for by some more moderate pharmacy benefits manager (PBM) reforms, including PBM transparency reporting and income based on service fees only.

Additional article: https://insidehealthpolicy.com/inside-drug-pricing-daily-news/wm-uses-patchwork-pbm-reforms-pay-telehealth-extenders-bill

(Some articles may require a subscription.)

#pbms #hospitalathome #telehealth #medicare

https://www.fiercehealthcare.com/regulatory/house-ways-means-committee-reveals-two-year-telehealth-extension-legislation

Read More »

Medicare Part A Trust Fund Has A Bit More Life

The Medicare Part A Insurance Trust Fund will be solvent for longer than previously projected says the annual Medicare Trustees report. While there are “significant financing issues,” the program will be able to pay all scheduled benefits until 2036, five years longer than the last report. No one can take policy credit (even though the Biden administration will try to do so) for meaningfully adding years to Medicare’s life.  It is all related to technical issues and occurrences. The truth is no party has a coherent policy to stabilize Medicare or entitlements for that matter. Benefit cuts or tax increases will be big if nothing is done.

Additional articles: https://www.beckershospitalreview.com/finance/medicares-financial-picture-brightens-slightly.html and https://thehill.com/policy/healthcare/4647137-medicare-fund-economy-solvent-yellen/

#medicare #entitlements #healthcare

https://www.fiercehealthcare.com/payers/medicare-hospital-trust-fund-extended-five-years-2036

Read More »

Biden Administration Rule Makes DACA Dreamers Eligible For Exchanges

Under a new rule, the Centers for Medicare & Medicaid Services (CMS) will make the Deferred Action for Childhood Arrivals (DACA) or dreamers eligible for Exchange enrollment. There are hundreds of thousands of Dreamers and the administration estimates that 100,000 will enroll.

Additional articles: https://www.fiercehealthcare.com/regulatory/daca-recipients-eligible-obamacare-under-cms-rule and https://www.modernhealthcare.com/politics-policy/biden-obamacare-access-daca-affordable-care-act-hhs-xavier-becerra

(Some articles may require a subscription.)

#exchanges #aca #obamacare

https://thehill.com/latino/4639985-biden-obamacare-dreamers-affordable-care-act-daca/

Read More »

Alignment Healthcare Reports Growth In Members But Continued Losses

Alignment Healthcare will report 165,000 increased enrollment at its Q1 2024 investor call, but a loss from operations of $41.1 million. This still means the insurtech likely is on its way to profitability.

#alignmenthealthcare #medicareadvantage

https://www.fiercehealthcare.com/payers/alignment-healthcare-raises-membership-guidance-posts-466-million-loss

Read More »

Available Now

$30.00