Innovation, payer reinvention, drug prices and price transparency, cybersecurity, getting paid for telehealth and investing in the social determinants as well as the continuing physician workforce shortage topped HFN's stories and trends for 2019. Here's a look back.
Insurers got repeal of the Cadillac tax, HIT and an extension of silver loading in year-end spending package.
House Energy and Commerce Committee also sends letters to physician staffing firms.
Most consumers say providers' willingness to share price information prior to service is a critical factor in determining where to seek care.
In contrast, taxpayers would face additional costs if manufacturer rebates were directly applied to insurers' pharmacy prices.
Suboptimal diet costs about $300 per person, accounting for 18% of all heart disease, stroke and type 2 diabetes costs in the country.
Drug companies have said they are hamstrung by the current pharmacy benefit manager system, says HHS Secretary Alex Azar.
When physicians bill out of network it means possible unexpected medical bills, undercutting the functioning of healthcare markets.
The Senate Finance Committee's bill would cancel planned cuts to Medicaid disproportionate-share hospital payments for 2020 and 2021.
Beyond cost, CMS said it adopted the lower payments for hospital outpatient facilities as a method to control unnecessary increases in volume.
The AHA is calling on CMS to "abandon further illegal cuts for 2020" that CMS says would save Medicare $800 million.
Use was disproportionately low across all hospital types, suggesting there's more hospitals could be going to get more people to use the record.
The bedside teams at RSFH's three hospitals will be supported by Advanced ICU Care's team of intensivists and nurses.
As the care delivery platform becomes more legitimate and accepted, governments, payers and providers are coping with the changes it will bring.
Intellectual property protections are needed for the ongoing discovery of drug treatments, PhRMA says.
Most patients showed willingness to use apps and online scheduling systems, but they were a lower priority than quality interactions. says.
Still, a new state-by-state survey from Foley & Lardner suggests there is still plenty of ground to cover in terms of telehealth payment parity, as well as the language used in the laws themselves.
It's the unanticipated consequence of the 2017 cut of the ACA's cost-sharing reduction payments to health insurers.
Health plans doing business in Medicare, Medicaid, ACA, are being asked to share claims data, and all information should be transferable, Verma says.
The rule will accelerate anti-competitive behavior among health insurers and stymie innovations in value-based care delivery, the groups say.
The government-wide MyHealthEData initiative is led by the White House Office of American Innovation.
The HFN team discusses some recent pieces of news from federal and state governments, and speculates on these developments.
The insurance group says it's supportive of more data sharing, but says CMS' timeline for API-enabled access is too aggressive.
At Maricopa Integrated Health System, price transparency became a top strategic imperative after it helped the system boost its margins.
CMS Administrator Seema Verma says agency is not afraid of legal push-back from providers or payers.
CMS releases final and proposed rules on price transparency bound to get provider and payer pushback
The final rule for hospitals, which goes into effect in 2021, includes the ability for CMS to impose civil monetary penalties of $300 per day.
The Omnibus Burden Reduction and Discharge Planning rules both aim to reduce red tape and enable transparency, says Centers for Medicare & Medicaid Services Administrator Seema Verma.
Legislative proposals could reduce bad debt, but would likely introduce additional complexity to billing processes.