Category: Healthcare Finance News

CMS overhauls Medicare ACO program by limiting upside risk to only two years

CMS sign at HIMSS17.
Administrator Seema Verma says it’s time for ACOs to take on downside risk, in a proposal that would save Medicare $2.2 billion over 10 years.

Amazon’s disruption binge continues with potential opening of primary care clinic at Seattle headquarters

Amazon office building.
Amazon’s tidal wave through healthcare industry continues as company is in talks to open primary care pilot clinic for select employees with plans to broaden access next year.

Advancing social determinants of health interventions needs pragmatic framework to justify investment, experts say

Sufficient funding is rare and providers hold back on investing in such programs thanks to inability to quantify benefits, understand delivery of services and insurance concerns.

CMS proposes additional rule to address risk adjustment

The 2018 benefit year will now determine risk adjustment payments to insurers, using the statewide average premium.

Big surge in numbers of hospitals and physician groups signing up for BPCI Advanced

Doctor and executive talking.
‘One nut that we haven’t really cracked is how we effectively engage patients,’ says bundled payment expert.

CVS MinuteClinic rolls out telehealth app with Teladoc

CVS MinuteClinic.
Pharmacy giant now offering telemedicine services in 10 US states with nationwide expansion planned by year’s end.

Academic Medical Centers are trailing their non-AMC counterparts in cost and quality, Navigant report says

AMCs show higher cost per case statistics and were hit with more penalties from value-based programs, survey says.

Tenet reports increased earnings but delay in sale of Conifer

As a result of divestiture activity at Tenet and other customers, Conifer’s revenue decreased 3.5 percent in Q2 2018 compared to last year.

NHS launches healthcare finance innovation initiative

Chelsea and Westminster Hospital.
Chelsea and Westminster Hospital NHS Foundation Trust’s charity CW+ is looking for startups or established companies with back office tech to either develop or tune for healthcare.

CMS is allowing Medicare Advantage plans to cross negotiate Part B and D drug prices

Starting in 2019, insurers may use step therapy to choose the least expensive drug first before moving on to another prescription.