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CMS wants ACOs to take on more risk. Here's how.

August 13, 2018


CMS is proposing replacing the current Medicare Shared Savings Program tracks with two options that accelerate the pathway for accountable care organizations to transition to two-sided risk models.

Mayo Clinic announces new CEO to replace Noseworthy

August 13, 2018


John Noseworthy, Mayo Clinic's current president and CEO, says Gianrico Farrugia, who will replace Noseworthy at the end of this year, "is a visionary and servant leader who brings with him a wealth of experience and knowledge—both as an innovator and an executive."

CMS will allow MA plans to implement step-therapy requirements for Part B drugs

August 13, 2018


Under a new CMS policy, Medicare Advantage plans beginning Jan. 1, 2019, will be able to implement step-therapy requirements for prescription drugs administered to beneficiaries at physician offices or hospitals—and President Trump says his administration soon will announce more policies intended to lower prescription drug prices.

The 'Hot Water Challenge': Inside the latest internet trend that has kids drinking boiling water

August 13, 2018


Hospitals across the country are treating burn patients who have consumed or had boiling water poured onto them as part of the so-called "Hot Water Challenge."

Payment bumps and price transparency requirements: Inside CMS' 2,610-page IPPS final rule

August 3, 2018


CMS' final rule for the Inpatient Prospective Payment System and Long-Term Acute Care Hospital (LTCH) Payment System for fiscal year 2019, which overhauls the meaningful use program and aims to improve hospital price transparency, will affect about 3,300 acute care facilities and about 420 LTCH facilities.

Patients aren't savvy health care shoppers, study finds

August 2, 2018


While price transparency tools are becoming more common, it turns out few patients are using them to shop around to find the lowest-cost, quality care—even in cases where a patient is seeking a non-emergent service, according to new research.

Centene, Ascension eye joint MA plan

August 1, 2018


Centene says it has signed a letter of intent with Ascension to launch a joint Medicare Advantage plan that would be "a preferred model" for the insurer and for providers in the Ascension health system, which is the largest nonprofit health system in the United States.

Diagnostic discordance occurs in about 85% of hospital transfers. Here's how providers are trying to do better.

August 1, 2018


A study finds that diagnostic discordance—when a patient receives different diagnoses after being transferred—occurs in roughly 85% of hospital transfers, and some hospitals are looking to resolve the issue.

Sanders' 'Medicare for All' bill would cost $32.6T—and change who is footing the bill

July 31, 2018


An analysis from the Mercatus Center at George Mason University estimates that Sen. Bernie Sanders' (I-Vt.) so-called "Medicare for All" proposal would cost about $32.6 trillion in new spending over the first decade—which observers say is slightly lower than what the United States is projected to spend on health care over the next ten years under its current health care system, though the proposal would shift who pays for the costs.

About half of US hospitals on average follow sepsis treatment guidelines, CMS data show

July 31, 2018


Hospital Compare data show that, nationally, 49% of hospitals on average followed sepsis treatment guidelines in the first nine months of 2017.

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