Category: Healthcare Finance News

American Hospital Association and PhRMA question legality of Most Favored Nation Model

The interim rule would cut drug reimbursements to hospitals by an average of 65% when fully phased in, the AHA says. 

CMS finalizes changes to Stark Law that hinder physician referral 

The old federal regulations burdened providers with added administrative costs and fear of financial consequences, CMS says.

HHS issues final rule ending pharmacy benefit manager drug rebates to insurers

Opponents say the rule will not lower drug prices and some question whether it is legal, having bypassed the public comment process.

Provider groups pressure Congress to freeze incentive payment thresholds for advanced APMs

The letter warns that the new thresholds are too high and will force many clinicians to exit from APMs and revert back to fee-for-service.

More than 803,000 select healthcare plans in the second week of open enrollment

It’s comparable to the first week of this year’s open enrollment, which saw 818,365 people sign up for coverage.

FDA approves first COVID-19 home test 

The test, which provides results in 30 minutes, is currently available by prescription only.

More than 1.1 million deaths among Medicare recipients are due to the high cost of drugs

Medicare negotiation could result in 94,000 fewer deaths annually, and reduce spending by $475.9 billion by 2030.

Intermountain Healthcare, United Way and more partner to address social determinants of health in Utah

This partnership plans to develop scalable programs for addressing the social determinants of health throughout the state.

Payer Notebook: Kaiser donates $1 million to the Bernard J. Tyson Impact Fund

AHIP names Humana CEO and President Bruce B. Broussard as chair for 2021.

Artificial intelligence in oncology care saved $3 million for one Texas provider

Automating risk stratification kept patients out of the ER, giving financial incentive to move to an alternative payment model.