Healthcare Economics

The deal will still need to be approved by federal and state regulators, but after delays in contract talks and an unsolicited bid from Brown University, the agreement advances Partners HealthCare’s aim of expanding beyond Massachusetts and matching the increased scale of other Boston-based health systems.
May 24, 2018 | Healthcare Economics
The Congressional Budget Office has scaled back its projections of coverage losses from the Affordable Care Act’s individual mandate being repealed, estimating 8.5 million people will be uninsured in 2027 due to the penalty being eliminated by Republicans’ tax legislation beginning next year.
May 23, 2018 | Healthcare Economics
After months of sitting out of the flurry of mergers and acquisitions between insurers and providers, Anthem has made its first move by announcing it will acquire Aspire, the largest non-hospice, community-based palliative care provider in the U.S.
May 23, 2018 | Healthcare Economics
The $20 billion in tax-exempt bonds not-for-profit hospitals sell on average every year can lead to $300 million going to banks and law firms handling debt deals—with those costs potentially encouraging hospitals to raise prices even as they’re exempt from paying taxes to their communities.
May 23, 2018 | Healthcare Economics
It marks the not-for-profit WEA Trust’s first entry into the private employer insurance market, having offered group coverage for Wisconsin state employees since its founding in 1970.
May 21, 2018 | Healthcare Economics
Reuters reports HCA’s proposal would essentially reverse Envision’s 2016 merger with AmSurg. The rest of the $5.1 billion Envision would be taken over by KKR.
May 21, 2018 | Healthcare Economics
UnitedHealth said it costs an average of $9,400 annually to cover a low-income, subsidized enrollee on the marketplace with $7,000 of that cost falling on the federal government. For someone eligible for Medicaid thanks to the Affordable Care Act (ACA), the overall cost is $5,400—with $5,100 coming from federal funds.
May 18, 2018 | Health IT
TransUnion Healthcare has announced the acquisition of reimbursement technology company Healthcare Payment Solutions (HPS). Adding HPS solutions to its portfolio will boost TransUnion’s position in the post-discharge revenue recovery technology market, the company said.
May 17, 2018 | Healthcare Economics
Three sponsors of Medicare Part D plans—UnitedHealth Group, Humana and CVS Health—account for more than half the program’s total enrollment. If proposed mergers involving smaller players like Aetna, Express Scripts and Cigna move ahead, the market would become even more concentrated.
May 16, 2018 | Healthcare Economics
Primary care physicians and non-physician practitioners have seen their compensation rise more rapidly than specialists, which the Medical Group Management Association (MGMA) said is evidence of the worsening shortage of primary care doctors.
May 16, 2018 | Quality
The report from Illinois' Cook County inspector general pinned much of the blame on the system’s bureaucracy, citing “a significant number of registration clerks, coders and billers who do not possess adequate self-motivation or the required skill sets and knowledge base” to do the jobs they’ve been assigned.
May 15, 2018 | Leadership
Health systems have made upgrades to revenue cycle solutions one of their top priorities in recent years, but C-suite leaders may not be happy with the results when it comes to reducing denials, according to a survey from Dimensional Insight and HIMSS Analytics.
May 15, 2018 | Healthcare Economics
Until 1980, the U.S. was similar to other countries in per capita spending and life expectancy. Princeton University sociology professor Paul Starr, PhD, said high inflation and sluggish economic growth in the late 1970s hurt countries’ abilities to afford healthcare. The difference was “other countries have been able to put limits on healthcare prices and spending” while the U.S. relied on market forces.
May 15, 2018 | Healthcare Economics
CMS has approved an extension of Maryland’s model of offering a fixed payment for most hospital services, allowing physician practices and nursing homes to voluntarily participate in a program that has saved Medicare hundreds of millions of dollars.
May 14, 2018 | Healthcare Economics
A data report released by the Kaiser Family Foundation and the Peterson Center on Healthcare showed the U.S. has higher prices for many healthcare services compared to other high-income countries, including on MRIs and joint replacements, and how some prices have risen faster than inflation.
May 11, 2018 | Healthcare Economics
Year-over-year price growth was 2.2 percent in April 2018, which Altarum said was fractionally above the March rate, setting a six-year high for price growth in the sector. Hospital price growth fell slightly to 3.7 percent.
May 10, 2018 | Care Delivery
After reporting nearly $18 million in savings for the employers current participating in its bundled payment programs for spinal surgeries and joint replacements, UnitedHealth Group announced it will expand the program to nine additional markets.
May 10, 2018 | Healthcare Economics
President Donald Trump is set to deliver a speech on pharmaceutical prices on May 11—but rather than matching his campaign rhetoric saying drug industry is “getting away with murder,” he’s expected to be cheered by pharma companies for calling for foreign countries to pay more for drugs, rather than bring down prices in the U.S.
May 09, 2018 | Healthcare Economics
When hospitals enjoy a monopoly in their market, their prices for privately insured patients are 12.5 percent higher on average, according to a study encompassing 88 million people covered by Aetna, Humana and UnitedHealthcare. The differences disappeared when consolidating facilities were located more than 25 miles apart.
May 09, 2018 | Healthcare Economics
Japan’s Takeda Pharmaceuticals has announced it will acquire Shire, an Ireland-based drug company, for $62 billion, making Takeda one of the 10 largest pharma firms in the world.
May 09, 2018 | Policy
Sen. Lamar Alexander, R-Tennessee, has said he’s abandoning efforts to push a bipartisan bill meant to stabilize the Affordable Care Act (ACA) exchanges, putting the blame on Democrats’ resistance to making changes to the law. With no congressional action likely this far into an election year, exchange insurers are requesting some eye-popping hikes for 2019 premiums.