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Jan 09, 2018
The CMS announced Tuesday a new voluntary bundled-payment model that will be considered an advanced alternative payment model under MACRA.

The Bundled Payments for Care Improvement-Advanced Model includes 32 clinical-care episodes that providers can choose from, 29 of which are in the inpatient setting and three in the outpatient setting.

The new model is the first advanced APM to be introduced by the Trump administration. The first cohort will begin Oct. 1. The model performance...

Jan 09, 2018

Ascension Health was one of the big names presenting on day two of the J.P. Morgan Healthcare Conference, and officials for the Catholic hospital giant talked about almost everything, the big exception being the reported merger talks with Providence St. Joseph. And Florida-based insurer WellCare Health Plans has a positive outlook regarding Medicaid. Reporters Tara Bannow and Shelby Livingston are gathering news at the conference. Find more news from them on Twitter at @TaraBannow and ,...

Jan 09, 2018

Puerto Rico's dwindling Medicaid coffers may get two years of full funding in the Senate's disaster aid package after negotiations for the same broke down in the House.

If Congress lifts the caps on the territory's Medicaid funding, Puerto Rico wouldn't have to cough up its usual share of Medicaid costs, which even before Hurricane Maria it hasn't been able to afford to do.

According to senior GOP aides and Congressional Hispanic Caucus aides close to discussions, the Senate...

Jan 09, 2018

Long Beach, Calif.-based insurer Molina Healthcare, which fired its CEO and chief financial officer in early 2017 for the company's poor financial performance, is in the midst of a major overhaul marked by layoffs and the sale of its primary-care clinics. Modern Healthcare reporter Shelby Livingston sat caught up with Molina's new president and CEO, Joseph Zubretsky, at the J.P. Morgan Healthcare Conference. A veteran Aetna executive installed at Molina just two months ago, Zubretsky...

Jan 09, 2018

The CMS now will cover more innovative insulin pumps for Medicare beneficiaries with diabetes. The move follows a congressional push for the agency to update its coverage policy.

In an under-the-radar notice issued Jan. 5, the CMS alerted Part D sponsors that they can cover new products on the market that deliver insulin. Older generation devices deliver insulin via a tube, while newer ones deliver the hormone though the skin directly.

Consumers and lawmakers had been...

Jan 09, 2018

HHS Secretary-designate Alex Azar has Medicare in his sights as the program that would epitomize his drug-pricing and payment model policies.

Azar's testimony before the Senate Finance Committee on Tuesday was marked by a promise to push value-based payments and a plug for Medicare Advantage, a program he helped to launch as HHS general counsel under George W. Bush.

Value-based payment models are one of his four core goals should he be confirmed, he told lawmakers.


Jan 08, 2018

The J.P. Morgan Healthcare Conference kicked off in San Francisco on Monday. Our reporters Shelby Livingston and Tara Bannow are there to offer daily observations and news.

Tenet continues road to revitalization with more job cuts

Tenet Healthcare Corp. will shed an additional 700 jobs on top of the 1,300 announced in the fall as part of the Dallas-based system's broader effort to find $250 million in savings, the company announced Monday at the J.P. Morgan Healthcare...

Jan 08, 2018

Maryland's unique rate-setting system for hospital services is getting a one-year extension from the federal government, Gov. Larry Hogan announced Monday.

The state's current all-payer hospital model contract will be extended from an expiration date of Dec. 31, 2018 to Dec. 31, 2019. The extension will give federal officials time to complete a review and consider four years of performance through the end of 2017.

"We're pushing to get it done," Hogan said. "They say in the...

Jan 08, 2018

The CMS is taking a hard look at whether regulations governing clinical laboratories need to be updated. Industry groups hailed the move, which they say is long overdue.

The Clinical Laboratory Improvement Amendments outline standards for U.S. facilities or sites that test human specimens for health assessments, as well as to diagnose, prevent or treat disease.

The CMS posted an request for information on Friday asking the industry for input on how the policies should be...

Jan 08, 2018

U.S. children experience higher mortality rates than children in 19 other developed countries, with most deaths occurring among infants and teenagers ages 15 to 19, according to a new study.

The study, published Monday in Health Affairs, found from 2001 to 2010 U.S. infants under 1 year old had a 76% higher risk of death than infants in other countries and 57% higher death risk among children ages 1 to 19. Additionally, infants and teenagers accounted for 90% of the more than 600,000...