Category: Healthcare Finance News

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.

Hospitals in one rural system have negative operating margins of $100 million a year, CEO says

Two areas for financial hope are being paid for telehealth and better data sharing in a rule on health information blocking.

Healthcare employee misuse and theft of pills totaled $164 million this year

Man stealing pills.
Hospitals and health systems should adopt better strategies to ensure physicians and nurses don’t shift pills to the black market.

CMS admits errors in MIPS payment calculations after ‘target review’ of payment factors

In addition to those whose scores were directly impacted, some clinicians will see small changes in their payment adjustment after reapplication of budget neutrality, CMS said.

Operating margins stunted for nonprofit hospitals, says Fitch

Labor and wage pressures for experienced staff will likely continue, while the shift to at-risk contracting will be an exacerbating factor.