Category: Healthcare Finance News

CMS touts Medicare Advantage plans ahead of October 15 open enrollment

MA enrollment is projected to increase while plans offer new types of supplemental benefits, CMS says.

Readmission drop for New York hospitals, but rates remain highest in the country

Tired patient in hospital.
About 90 percent of New York hospitals will be penalized next year, and while that number is high, it’s down 3 percent from 2018.

OIG report finds a high rate of overturned denials in MA plans

The report raises questions of whether Medicare Advantage plans inappropriately deny claims to increase profits.

Next generation of medical professionals underprepared for machine learning, say researchers

Medical school and residency programs have an untapped opportunity to educate clinicians about using AI in patient care.

Aetna is divesting its Medicare Part D plans to WellCare

The sale will be completed by the end of the year but is contingent upon the closing of its merger with CVS Health.

Health plans not meeting Medicare beneficiaries’ communication preferences, survey shows

There is still a demand for voice and regular mail as communication methods, but that demand is shrinking.

CFOs share innovation investment strategies amid political uncertainty in DC

Chief financial officers of Northwell, Providence St. Joseph and Henry Ford simply refuse to be prisoners of ever-changing federal government rules and regulations.

How Eastside Health Network has been smoothing the path to value-based care by normalizing data

EHN knew it has to get a better handle on disparate EHR systems, bringing data together in ways that were actionable.

House passes bills prohibiting pharmacy gag clauses on drug prices

Congress
The Patient Right to Know Drug Prices Act and the Know the Lowest Price Act are expected to get President Trump’s signature.

Community Health Systems’ subsidiary to pay more than $260 million over alleged kickback, billing, inpatient admissions scheme

Government alleged HMA unlawfully boosted inpatient admissions, submitted inflated claims to government payers and paid physician kickbacks for referrals.