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Industry News

Apr 23, 2018

The CMS is planning to launch a new pay model that would allow Medicare beneficiaries to contract directly with physicians.

Under current law, physicians are paid under a fee schedule in Medicare that includes limits on the amount they can bill beneficiaries per service unless they choose to opt out of Medicare and privately contract with all of their Medicare patients.

Apr 23, 2018

Providence St. Joseph Health is betting on its diverse leadership team to help the integrated health system navigate a new strategic direction.

The Renton, Wash.-based not-for-profit system, which has 51 hospitals and more than 800 facilities across seven states as well as its own health plan, recently embarked on a new direction that involves extending its ambulatory network,...

Apr 23, 2018

Texas is revising its Medicaid coverage policies after reports that U.S.-born children with lawfully present foreign parents were being barred from the program due to their sponsors' income.

Going forward, Texas' Medicaid agency will not use the income of a legal alien's sponsor to determine eligibility for that person's U.S.-born child, since that practice violates federal law, according to state officials. The sponsor's income will still be used to determine the parents' Medicaid...

Apr 23, 2018

A group of hackers called Orangeworm has been sneaking into healthcare companies' computer systems, according to Symantec.

Of the nearly 100 companies breached by the group, 39% were in healthcare, according to Symantec. The group has targeted between 24 and 36 organizations this year alone, including companies in healthcare, IT, manufacturing and logistics.

The hackers have broken into imaging devices, like x-ray and MRI machines, as well as computers related to patient...

Apr 20, 2018
Las Vegas resident Vertis Boyce has always liked to travel to visit friends and family. But for the past 9½ years, her travel has been limited by her need for dialysis treatments. Boyce experienced renal failure in 2008 due to a combination of high blood pressure and a genetic disposition.

"Traveling was an inconvenience because I always had to set up appointments for dialysis in each city that I would visit," Boyce said.

Things changed for the better however last July, when Boyce,...

Apr 20, 2018
Along with the rest of the industry, Modern Healthcare is eager to hear what President Donald Trump has to say about drug prices. But that's not all we are watching this week:

April23:ClosingdayforcommentsontheCMS'proposedrule seeking to expand short-term insurance plans. As of late last week, more than 6,500 comments were already filed with the agency. In a cursory review online, Modern Healthcare found that the bots have been busy. Page after page of comments shared the same opening lines...

Apr 20, 2018
Everycornerofthehealthcareindustryisfeelingpressure to deliver greater value. Achieving real and sustained results requires greater collaboration.

In this unique two-day event on June 7-8 in Austin, Texas, Modern Healthcare will bring together senior executives from hospitals and health systems, suppliers, payers, venture capitalists and others to share ideas on how to break down silos. The event offers attendees an exclusive opportunity to gain insights into the strategies used by...

Apr 20, 2018

County courtrooms are no strangers to contract disputes between local hospitals and insurers. Lately, though, they've had some big cases dropped in their laps as hospitals owned by HCA Healthcare, Sentara Healthcare and Piedmont Healthcare take health insurance giant Anthem to court over its new policies that restrict outpatient imaging and emergency department reimbursement.

Typically, state courts hear arguments pertaining to relatively minor contract disputes, such as coverage of...

Apr 20, 2018

The Food and Drug Administration on Friday encouraged drugmakers to conduct fewer clinical trials on certain proposed medication-assisted therapies for opioid use disorder, saying a streamlined approach will help patients access treatment quicker.

In a draft guidance released Friday, the FDA said some so-called "depot buprenorphine products" don't need new safety and efficacy clinical trials, a move that could avoid unnecessary duplication of studies performed on a similar product...

Apr 20, 2018

Emory Healthcare and Walmart will create an accountable care organization to serve about 10,800 Walmart employees in the metro Atlanta area. The ACO will include a bundled-payment program for spine surgery and joint replacement.

Workers at 55 Walmart and Sam's Club locations can opt into the ACO. Covered workers will still make standard copayments for primary, specialist, and urgent care, but their preventive-care visits will be free. Emory, an academic center, is one of Georgia's...