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Minnetonka, Minnesota-based Medica has reached a deal with Mayo Clinic to acquire its Mayo Clinic Health Solutions division, also known as MMSI, for an undisclosed sum.

In a first for the Internal Revenue Service (IRS), it stripped a hospital’s nonprofit tax status over failing to meet charity care requirements which went into effect, though the unnamed hospital also claimed it didn’t want or need tax-exempt status.

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.

 

Recent Headlines

CMS: Medicaid DSH payments will consider what Medicare, third-party pay

In a final rule issued on March 30, CMS clarified uncompensated care costs for Medicaid patients are limited by what a hospital received from other sources, such as commercial insurers, Medicare or the patients themselves.

ACHE 2017: Creating a provider-sponsored health plan means understanding your market

The lines are blurring between healthcare providers and payors as more providers are sponsoring their own health plans or partnering with payors. Unfortunately for interested providers, that greater prevalence hasn’t come with any one-size-fits-all approach for making these plans succeed.

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.

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