The Latest

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  Medicare reveals results of drug price negotiations

  The agency said the first round of pricing talks, which involved drugs like the blood thinners Eliquis and Xarelto, will result in $6 billion in savings for taxpayers.

  Payer

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  Sponsored by Point Click Care

  Navigating industry challenges: Policy, tech and the road ahead

  LTPAC professionals claim they're the second most regulated industry in America after nuclear power. Regardless, senior care operators face extensive regulations.

  Health IT

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  Unsealed court filings offer details of DOJ investigation into Prospect Medical

  The documents released Tuesday say Prospect is under federal investigation for possible False Claim Act violations, and faces state investigations for failing to safeguard patient data before a ransomware attack last year.

  Hospitals

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  Kaiser Permanente rolls out Abridge’s AI documentation tool

  The product, which uses AI to summarize medical information from conversations between patients and clinicians, is now available across Kaiser’s 40 hospitals and more than 600 medical offices.

  Hospitals

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  Elevance, Clayton Dubilier and Rice unveil primary care venture Mosaic Health

  New information is emerging about the joint care delivery platform first teased earlier this spring, which is launching without Elevance’s assets.

  Payer

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  Medicare Advantage prior authorization denials increased in 2022: KFF

  More than 80% of denied requests were overturned when appealed, but few beneficiaries formally questioned the decisions.

  Payer

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  Overturning of Roe v. Wade

  Texas women say hospitals violated EMTALA by denying emergency abortions

  The patients’ complaints to the HHS allege two Texas hospitals denied them emergency abortion care for ectopic pregnancies, risking their lives and damaging their future fertility.

  Hospitals

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  Tracking Steward's decline

  Steward to sell physician group to private equity firm for $245M

  It’s a major win for bankrupt Steward, which has sought to offload its physician group since December. 

  Hospitals

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  Kaiser’s operating margin rises to 3.1% in second quarter

  The nonprofit healthcare giant's results represent a strong quarter and a solid end to the first half of the year, one analyst said.

  Hospitals

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  Stryker to buy smart hospital technology firm Care.ai

  Stryker said the company will strengthen its growing health IT offering and portfolio of wirelessly connected medical devices.

  Health IT

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  For-profit health systems see Medicaid supplemental payment bump in Q2

  However, hospital executives said the uptick in supplemental funding still wasn’t enough to cover their costs.

  Hospitals

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  Nonprofits’ cash on hand hit 10-year low in 2023: report

  S&P Global also found no "meaningful" improvement in cash flow for providers between 2022 and 2023.

  Hospitals

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  Prospect Medical to sell Crozer Health to real estate company CHA Partners

  Prospect has sought to divest the struggling four-hospital system since 2022.

  Hospitals

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  In tone-setting verdict, FDA rejects MDMA as a therapy aid for PTSD

  The decision to turn down an application comes at a pivotal time for psychedelics research, which has recently gained momentum after decades of dismissal.

  Updated Aug. 9, 2024

  Government

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  McLaren Health Care confirms cyberattack after IT system disruptions

  The latest attack on the Grand Blanc, Michigan-based health system comes less than a year after it was hit by a ransomware attack.

  Hospitals

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  Walgreens considering full sale of VillageMD

  The decision, disclosed Wednesday in a securities filing, is a sharp reversal to the pharmacy behemoth’s past commitment to building out its healthcare delivery offerings.

  Finances

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  Included Health taps Optum exec as CFO

  Mark Flakne comes to the virtual and in-person care company from Optum, where he worked for more than 11 years.

  Health IT

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  After decline, private equity investment in healthcare reaches turning point: PitchBook

  Private equity dealmaking fell more than 16% in the second quarter, but the market is showing signs of a turnaround, according to the market research firm.

  Finances

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  Aetna executive ousted as CVS’ Medicare Advantage woes drag into second quarter

  On Wednesday, CVS slashed its earnings guidance for the third time this year, announced a plan to cut $2 billion in costs and fired the head of its insurance division Aetna, which continues to struggle with high medical utilization.

  Payer

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  CMS finalizes notice on Medicare coverage for breakthrough devices

  The CMS will consider five medical device candidates yearly for national coverage through the new pathway, called Transitional Coverage for Emerging Technologies.

  Payer

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  Uninsured rate jumps to 8.2% amid Medicaid unwinding: CDC

  Growth in the nation’s uninsured rate could become steeper if subsidies in the Affordable Care Act exchanges expire on schedule next year, according to health policy experts.

  Payer

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  More than 700 rural hospitals at risk of closing: report

  One challenge hospitals face is reimbursement from private payers, which doesn’t cover the higher costs of care in rural areas, according to a report by the Center for Healthcare Quality and Payment Reform.

  Hospitals

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  Premiums for ACA plans to grow 7% next year: KFF

  Insurers cited workforce shortages, hospital consolidation and growing demand for pricey GLP-1 drugs as reasons driving the premium increases for 2025.

  Payer

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  Surprise Billing

  Appeals court hands providers latest win in No Surprises litigation

  The 5th Circuit Court’s decision vacates instructions that arbiters should first consider the qualifying payment amount in deciding payments over contested out-of-network bills. Providers argued that unfairly advantaged insurers.

  Hospitals

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  Experts fear patient harm from FDA’s lab developed test rule

  Decreased access to diagnostic tests, worsening patient care and practice closures are among the concerns the AMA and others have raised as the regulation takes effect.

  Government

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  Tenet to sell majority stake in 5 Alabama hospitals for $910M

  The health system has divested a string of hospitals this year as it seeks to pay down debt and refocus its portfolio on ambulatory surgery centers.

  Hospitals

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