You are here

Finance

 

If payment of cost-sharing reduction subsidies, or CSRs, for insurers offering coverage on the Affordable Care Act (ACA) marketplace are terminated, premiums would be 20 percent higher on average in 2018 and federal spending would increase, but the ACA market would remain stable, according to the Congressional Budget Office.

When it comes to finding waste in their labor costs, healthcare leaders need to sweat the small stuff, according to Chip Newton, senior manager at Deloitte Consulting LLP.

CMS has pushed back the deadline for insurers to file their final 2018 rate requests for the Affordable Care Act (ACA) exchanges until Sept. 5, giving companies extra time to decide what plans and prices to offer.

Two studies published in the August edition of Health Affairs emphasized while patients like the idea of having healthcare prices available for comparison shopping, in practice, few actually take advantage of the tools.

A proposed rule from CMS offered greater detail on the methodology for implementing the Affordable Care Act’s $43 billion in cuts to Medicaid Disproportionate Share Hospital (DSH) payments between 2018 and 2025.

 

Recent Headlines

AHCA could lead to 725,000 fewer healthcare jobs

The Republican-sponsored American Health Care Act (AHCA) could “trigger an economic downturn in nearly every state,” according to a new report from George Washington University’s Milken Institute School of Public Health and the Commonwealth Fund, with the majority of the job losses coming from the healthcare industry.

AMA 2017: Outpatient services to drive profitable growth for health systems

Health systems looking for ways to grow profits should focus on sites of care and know what kind of insurance plans their patients may be utilizing, with much of the growth being seen in outpatient services.

10 costliest claims conditions account for $1.3B from 2013 to 2016

Sun Life has released its fifth annual “Sun Life Stop-Loss Research Report," outlining the top 10 catastrophic claims conditions. The report provides data from 53,000 claimants and $4.5 billion in stop-loss reimbursements to project changes over time in costs of medical conditions.

Med groups to CMS: Include Medicare Advantage patients under Advanced APMs

Ten healthcare industry groups, including the American Medical Association, have asked CMS to allow Medicare Advantage (MA) patients to count towards the threshold requirements to qualify as an Advanced Alternative Payment Model (APM).

New York public hospitals eliminating 476 positions

The largest public health system in the U.S., NYC Health + Hospitals, announced on June 2 it will lay off 396 managers and eliminate 80 currently unfilled positions as it faces a projected budget of $6 billion through 2020.

Insurers favor value-based contracts, but few are available

The majority of health plans responding to a Avalere Health survey said they have favorable attitudes towards value-based contracts, though smaller numbers of insurers are actually pursuing or have entered into those agreements.

EDs may charge 12.6 times Medicare prices—with higher markups than other departments

Emergency department services like suturing a wound or interpreting a CT scan may result in patients being charged up to 12.6 times more than what Medicare would pay, with minorities and uninsured patients the most likely to be hit by the markups.

Aetna moving its HQ out of Connecticut, considering ‘several states’

Aetna confirmed it is in negotiations to move its corporate headquarters out of Hartford, Connecticut, which was been its home since it began as a fire insurance company in 1819.

CHS to sell 5 hospitals to Reading Health System

The selloff of Community Health System (CHS) hospitals is continuing, as the struggling hospital operator agreed to sell five Pennsylvania hospitals to the not-for-profit Reading Health System.

Steward would become largest for-profit hospital operator after IASIS merger

Boston-based Steward Health Care System would become the largest for-profit hospital operator in the U.S. if it wins regulatory approval for a $2 billion merger with Franklin, Tennessee-based IASIS Healthcare. 

Pages