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Four accountable care organization (ACO) models generated more in gross savings in 2016, but unlike in previous years, CMS hasn’t publicly touted the results as it re-examines payment models created under the Centers for Medicare and Medicaid Innovation (CMMI).

The U.S. Department of Justice (DOJ) has abandoned a lawsuit against UnitedHealth over allegations the insurer submitted false claims in its Medicare Advantage plans, though a similar case remains active.

Private investors are becoming increasingly active in healthcare acquisitions, which may maximize the purchase price when practices decide to sell, but there are downsides to these transactions compared to be absorbed into a hospital or health system.

The new administration at CMS and HHS has signaled it wants to take a different path on value-based care models. Some have been clear actions, like ending mandatory bundled payment models in cardiac care. The next step may be more driven by stakeholders, as CMS recently released a request for information (RFI) asking what new models developed by the Centers for Medicare and Medicaid Innovation (CMMI) should look like.

The JPMorgan Chase Institute Healthcare Out-of-pocket Spending Panel (JPMCI HOSP) included 2.3 anonymized Chase customers from 18 to 64 years old between 2013 and 2016. The study examined trends in out-of-pocket healthcare spending in 23 of the 50 United States and their effects on household financial standings.

 

Recent Headlines

Positive results for ACO models, but CMS doesn’t publicize results

Four accountable care organization (ACO) models generated more in gross savings in 2016, but unlike in previous years, CMS hasn’t publicly touted the results as it re-examines payment models created under the Centers for Medicare and Medicaid Innovation (CMMI).

DOJ drops Medicare Advantage fraud suit against UnitedHealth

The U.S. Department of Justice (DOJ) has abandoned a lawsuit against UnitedHealth over allegations the insurer submitted false claims in its Medicare Advantage plans, though a similar case remains active.

MGMA17: Pros and cons of selling a practice to private equity

Private investors are becoming increasingly active in healthcare acquisitions, which may maximize the purchase price when practices decide to sell, but there are downsides to these transactions compared to be absorbed into a hospital or health system.

Donations to U.S. nonprofit hospitals up 5% in 2016

Nonprofit hospitals and health systems in the U.S. raised more than $10.1 billion in fiscal year 2016, a 5 percent jump from the year before, while their Canadian counterparts saw their first increase in donations since 2013.

Q&A: What could a ‘new direction’ mean for CMMI’s payment reforms?

The new administration at CMS and HHS has signaled it wants to take a different path on value-based care models. Some have been clear actions, like ending mandatory bundled payment models in cardiac care. The next step may be more driven by stakeholders, as CMS recently released a request for information (RFI) asking what new models developed by the Centers for Medicare and Medicaid Innovation (CMMI) should look like.

6 stats from JPMorgan Chase study of 2.3M families’ healthcare spending

The JPMorgan Chase Institute Healthcare Out-of-pocket Spending Panel (JPMCI HOSP) included 2.3 anonymized Chase customers from 18 to 64 years old between 2013 and 2016. The study examined trends in out-of-pocket healthcare spending in 23 of the 50 United States and their effects on household financial standings.

Providers lagging behind offering payment options patients want

Patients are expecting more flexible payment options, both in terms of how and when they pay their balances. Yet hospitals—and to a slightly lesser extent group practices—don’t appear to be providing all the tools patients have requested, according to a survey released by the Medical Group Management Association (MGMA) and Navicure.

267,000 healthcare jobs would be eliminated under latest ACA repeal plan

The Graham-Cassidy legislation to repeal the Affordable Care Act (ACA) would cause an immediate downturn in healthcare employment, amounting to more than 267,000 fewer jobs in the industry by 2026, according to a report from George Washington University’s Milken Institute School of Public Health and the Commonwealth Fund.

Moody’s: Despite ACA uncertainty, health insurers’ outlook stable

U.S. health insurers maintained a stable outlook in the latest report from Moody’s Investor Service, with the rating agency expecting insurance companies “will continue generating solid results owing to disciplined medical management and moderate medical cost trends.”

UPMC buys 50% stake in Rome hospital

University of Pittsburgh Medical Center (UPMC) has expanded its operations in Italy, buying a 50 percent stake in the 75-bed Salvator Mundi International Hospital in Rome and taking over clinical operations.

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