Healthcare Economics & Policy

The trend of costs increasingly being shifted onto patients continued in 2017 with average out-of-pocket costs hitting $1,813 in 2017, an 11 percent jump from the year before, according to an analysis released by TransUnion Healthcare at the HIMSS18 conference in Las Vegas.

This year, providers may be struggling with meeting deadlines on reporting for the Merit-based Incentive Payment System (MIPS) and avoiding a negative payment adjustment. In a few years, however, they’ll expect solutions to more complicated issues surrounding value-based reimbursement, according to Tim Mills, chief growth officer at revenue cycle, coding and billing software company Alpha II.

The Trump administration’s plans to expand the availability of association health plans could siphon up to 4.3 million people from the individual and small group insurance markets over the next five years, raising premiums on those who remain in plans which are compliant with the Affordable Care Act (ACA).

A large majority of medical group professionals responding to a poll from the Medical Group Management Association (MGMA) was opposed to mandatory participation in alternative payment models in Medicare, a policy CMS has been moving away from under President Donald Trump.

In an interview on CNBC, billionaire Warren Buffett said the healthcare-focused venture formed by his Berkshire Hathaway along with Amazon and JPMorgan has greater aims than trimmed some healthcare costs or cutting out middlemen.

Patients are getting fed up with healthcare organizations who haven’t made their payment processes and communications as convenient as other industries. With Silicon Valley giants like Apple and Amazon eyeing the healthcare space, the time to ditch old, inefficient methods is now, according to Deirdre Ruttle, vice president of strategy at payment networks company InstaMed.

Premiums on the Affordable Care Act (ACA) exchanges could be in for another double-digit increase if HHS moves ahead with a proposed rule to expand the availability of short-term insurance plans which don’t comply with the ACA.

In 2015, then-HHS Secretary Sylvia Burwell announced an ambitious goal for half of all Medicare payments to be tied to value-based care models by the end of 2018—but that’s not a priority for the agency under President Donald Trump, a CMS spokesperson told the Washington Post.

Two Catholic health systems, Maryland-based Bon Secours and Cincinnati’s Mercy Health have announced plans to merge into a 43-hospital system stretching across seven states in the eastern half of the U.S.

The tax cut legislation signed into law late last year will help most for-profit hospitals in 2018, boosting their bottom lines at a time when several major chains are struggling with weak admissions and making acquisitions and capital investments more attractive.

Three months after the transaction was first announced, St. Louis-based Ascension Health and Chicago’s Presence Health have signed a definitive agreement for Presence to join Ascension’s existing joint venture in Illinois, AMITA Health.

The U.S. Department of Justice (DOJ) can move forward with a lawsuit alleging UnitedHealth Group wrongly collected more than $1 billion through Medicare Advantage by finding conditions to increase a patient’s risk adjustment payment from CMS.