New data released by CMS shows ACOs cut Medicare costs by hundreds of millions of dollars after accounting for shared savings payments. The National Association of ACOs said the data proves Track 1 ACOs are generating savings.
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Payer Roundup—Baldwin introduces bill to overturn AHP rule; DOJ wants new judge in work requirements case
A joint resolution introduced this week in the Senate with 30 co-sponsors would overturn the administration’s recent expansion of association health plans. Plus: The Department of Justice says the judge assigned to the Arkansas work requirements is … i…
Physician groups say CMS’ change to drug formularies shifts decisions from doctors’ hands to insurers
Physician and patient advocacy groups are not happy with the latest effort by the Trump Administration to lower drug costs, saying it takes decisions out of doctors’ hands and will limit treatments for patients.
CMMI director: Home visits could be focus of upcoming Medicare demos
As founder of Landmark Health, Adam Boehler sees home visits as one way to move from volume to value. To fill the physician gap, nurses and other medical professionals could join in this effort.
Court tosses NorthBay’s antitrust suit against Kaiser once and for all
For the third time in less than a year, a district court dismissed antitrust complaints brought against Kaiser Permanente. And the court sent a strong message to the plaintiffs that they need to revise their strategy.
CMS loosens restrictions on Part D drug formularies to allow indication-based coverage
In a memo to Part D plan sponsors on Wednesday, CMS issued new flexibilities for “indication-based” drug formularies that will allow plans to add or exclude drugs for specific conditions.
Insurers say a small change to FCC regulations will have a big impact on their ability to text and call patients
More than two years after petitioning the FCC to clarify its rules around communicating with patients, a group of insurers and the American Association of Healthcare Administrative Management are reigniting the fight they say helps improve patient care…
Pre-existing conditions vary widely between metropolitan areas, report says
A new map from the Kaiser Family Foundation shows the wide variability of pre-existing conditions and the potential impact that healthcare protections could have on metropolitan regions around the U.S.
Patients with the most to gain from digital health hardly engage with new tools
Maintaining the human element and keeping out-of-pocket costs down could be key to expanding telemedicine and wearable devices, according to the latest Rock Health survey, particularly among chronic care patients that have the most to gain.
More than 150 medical groups oppose CMS proposal to change E/M codes
Saying it could underpay doctors who treat the sickest patients, more than 150 medical groups sent a letter opposing a government plan to consolidate evaluation and management (E/M) codes.
