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Medicare's surprising slowdown: Why per-person costs are falling—and what the health system can learn from it

September 18, 2018

When actuaries detected a slowdown in Medicare spending growth a few years ago, Medicare officials claimed it was a one-time blip due to the recession. But one expert is spearheading research that paints a different picture—revealing a sustained slowdown in spending that the larger health care system could learn from.

DOJ OKs proposed Cigna-Express Scripts merger

September 18, 2018

Makan Delrahim, assistant attorney general of the Department of Justice's antitrust division, says, "After a thorough review of the proposed transaction, the antitrust division has determined that the combination of Cigna … and [Express Scripts] … is unlikely to result in harm to competition or consumers."

1 in 4 people with diabetes have rationed insulin. Here's why that's dangerous.

September 14, 2018

About one in four diabetics has resorted to rationing their insulin doses to combat rising prices—but the practice can have lethal consequences.

400% Rx price increase was 'moral requirement,' pharma CEO insists

September 13, 2018

In response to questions about a recent 400% price increase for the antibiotic nitrofurantoin, Nostrum Laboratories CEO Nirmal Mulye says, "I think it is a moral requirement to make money when you can … to sell the product for the highest price," adding that he is in the pharmaceutical "business to make money."

As ED prices rise, more patients are seeking care at retail clinics

September 12, 2018

Researchers say ED visits for low-acuity conditions declined by 36% from 89 visits per 1,000 members in 2008 to 57 visits per 1,000 members in 2015, while non-ED visits for low-acuity conditions increased by 140% from 54 visits per 1,000 members in 2008 to 131 visits per 1,000 members in 2015.

Are MSSP ACOs hitting target savings? CMS says no, but a new report pushes back.

September 12, 2018

A new report from the National Association of ACOs finds that accountable care organizations (ACOs) participating in the Medicare Shared Savings Program generated $1.84 billion in savings between 2013 and 2015—nearly twice as much as the $954 million CMS data show the ACOs saved.

How these experts would invest in public health

September 6, 2018

Top public health experts say the United States should invest more in interventions that have been proven to work, such as school- and community-based health programs.

How Comcast—yes, Comcast—is reinventing health insurance

September 6, 2018

As employers struggle to rein in rising health care costs, cable company Comcast is keeping health care costs practically flat—without subjecting employees to high-deductible health plans.

MSSP ACOs saved Medicare $313.7M last year, CMS data show

September 4, 2018

New CMS data show 60% of the accountable care organizations (ACOs) that participated in the Medicare Shared Savings Program for the 2017 performance year generated a total of about $1.1 billion in savings, while CMS paid about $780 million to ACOs in bonuses under the program for that year.

Nonprofit hospital margins are at an all-time low, Moody's report shows

September 4, 2018

A report from Moody's Investors Service shows nonprofit and public hospitals saw revenues decline at a faster rate than spending for the second consecutive year in fiscal year 2017.

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