Category: Modern Healthcare

NQF kicks off annual review of proposed new CMS quality measures

NQF’s Measure Applications Partnership has 39 measures to consider. The CMS said it chose the measures based on its Meaningful Measures framework.

Fitch: Healthcare pricing, profit margin pressure will persist in 2019

Fitch Ratings predicts the U.S. healthcare sector will be stable in 2019, but don’t expect the pressure on pricing and profit margins to let up any time soon.

Vanderbilt to keep Medicare funding after CMS threatened revocation

The CMS has accepted Vanderbilt University Medical Center’s correction plan to maintain its Medicare contract, after threatening to pull it for failures around the 2017 wrongful death of a patient.

Medicare could be overspending billions for lab tests

A government watchdog warned that Medicare could be incurring major losses on laboratory tests, even though the CMS has reformed its payment system.

Editorial: The canary in the 
open enrollment 
coal mine

The share of Americans without health coverage will undoubtedly tick up next year for the first time in nearly a decade. This dubious achievement arrives just as the U.S. economy is nearing full employment. This shouldn’t be happening.

NYC hospitals selling companies at center of captive insurance scheme

Prominent New York City health systems are selling an insurance company and third-party administrator that state regulators last year found had engaged in a scheme to funnel hundreds of millions of dollars back to the hospitals.

Advocate Aurora to increase minimum wage

The 10th-largest nonprofit hospital network in the nation says it will increase its minimum wage to $15 an hour in 2021.

More eHealth customers choosing short-term insurance plans

Many more eHealth customers opted for short-term insurance plans over unsubsidized Affordable Care Act-compliant plans during the first half of the ACA open enrollment period for 2019 coverage than during the previous open enrollment.

Beth Israel-Lahey Health merger clears final approval with conditions

Massachusetts’ attorney general put conditions on the merger, including a seven-year price cap, participation in MassHealth, and $71.6 million in investments supporting healthcare services for low-income and underserved communities in Massachusetts.

CMS allows states to get creative with federal exchange funds under 1332 waivers

The CMS has issued four new examples on how states can use 1332 waivers to customize health insurance offerings. But a former agency official warns that use of any of the new flexibilities outlined could result in litigation.