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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

Anthem likely to leave ACA markets for 2018

Financial analysts are predicting Anthem, one of the nation’s largest health insurers, will be following other national companies in leaving the Affordable Care Act’s exchanges in 2018.

500,000 healthcare jobs added because of ACA

A new analysis from Goldman Sachs said that 500,000 of the jobs added to the healthcare sector since 2012 can be attributed to the Affordable Care Act (ACA)’s increasing of health insurance coverage. 

Cleveland Clinic operating income drops by 71%

Revenues were up at the Cleveland Clinic in 2016, but higher expenses put a damper on operating income, which fell 71 percent from the year before.

Former Anthem lobbyist to be nominated to run DOJ’s antitrust division

The specific division of the U.S. Department of Justice that fought Anthem’s $54 billion acquisition of Cigna—and which the insurers is still pushing to approve the merger over antitrust concerns—could be run by a former Anthem lobbyist.

Mayo Clinic facing state review for prioritizing privately insured patients

Mayo Clinic is being reviewed by the Minnesota Department of Human Services (DHS) for possibly breaking civil and human rights laws after comments from CEO John Noseworthy, MD, encouraging employees to prioritize commercially insured patients over Medicare and Medicaid beneficiaries.

Winners and losers in Trump’s proposed budget for HHS

President Donald Trump’s budget proposal for 2018 would reduce funding to HHS by $15.1 billion, a cut of nearly 18 percent, eliminating millions for education and training programs for healthcare professionals, while cutting $5.8 billion from the National Institutes of Health (NIH) alone.

Utilizing hospitals’ internal cost data could improve accuracy of new payment models

In an attempt to obtain greater accuracy on cost estimates, hospitals have developed their own internal systems to identify services with high and low profit margins and control spending. If what they’ve come up with is more detailed than what CMS uses, shouldn’t CMS be using that data?

Massachusetts hospital blamed for Medicare underpayments in other states

Miscalculations by Nantucket Cottage Hospital in Massachusetts in wages and costs in 2015 resulted in Medicare paying all hospitals in the state $133 million more than it should—creating a chain reaction that resulted in hospitals around the country being underpaid by CMS.

Pinnacle to affiliate with UPMC, buy 4 hospitals

Harrisburg, Pennsylvania-based Pinnacle Health announced it will more than double the number of hospitals within its system while also beginning an affiliation with the state’s largest health system, University of Pittsburgh Medical Center (UPMC). 

Fairview, HealthEast plan merger into 11-hospital system in Minnesota

Fairview Health Service and HealthEast Care System have announced their intention to merge, creating what is likely the largest health system in the Minneapolis-St. Paul area with a combined $5 billion in annual revenue.

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