Category: News

January 18, 2024

ALISON BENNETT  

The Centers for Medicare and Medicaid Services is testing a new community-based behavioral health services model that aims to improve access and quality, the Health and Human Services Department announced Thursday.

Under the Innovation in Behavioral Health Model, physical and mental healthcare providers will form interprofessional care teams with community organizations, which will coordinate care for Medicare and Medicaid enrollees with mental illnesses and substance-use disorders.

January 04, 2024

MARI DEVEREAUX   

Hospitals purchased by private equity firms have higher rates of adverse patient safety events than other facilities, according to a recent study, and its authors said the findings could be indicative of how the acquisitions affect hospital operations.

The study published in JAMA found hospital-acquired conditions like surgical infections and pressure ulcers increased by 25% among Medicare patients at private equity-owned facilities compared with a control group of hospitals.

December 05, 2023

MARI DEVEREAUX   

Physicians leaving private practice for employment has hurt patient care quality, according to a recent survey of doctors commissioned by the Physicians Advocacy Institute. 

The survey polled 1,000 physicians employed by insurers, health systems, staffing agencies and private equity firms on how corporate ownership affects their workplace experience and ability to meet patients’ needs. The research was conducted by NORC at the University of Chicago.

July 13, 2023

CAROLINE HUDSON   

Medical practices are getting larger, and physicians are less likely to own them, according to a report from the American Medical Association.

Carol Kane, AMA’s director of economic and health policy research, compiled the report released Wednesday by analyzing data from the association’s biennial Physician Practice Benchmark Surveys from 2012 to 2022. The most recent survey was conducted in late 2022 and included data from 3,500 post-residency physicians.

November 21, 2023

LAUREN BERRYMAN   
BROCK E.W. TURNER 

The alleged use of artificial intelligence for prior authorization and claim denials has led to lawsuits against two major health insurance companies.

UnitedHealth Group and Cigna have been separately accused of allegedly using automated tools to deny some claims, which plaintiffs say reduces the insurers’ labor costs. Both policymakers and physician leaders are asking insurance companies to open up their AI playbooks in response to these allegations.

November 02, 2023

ALISON BENNETT 

Physicians will be hit with a 1.25% reduction in Medicare reimbursements next year under a final rule the Centers for Medicare and Medicaid Services issued Thursday.

The American Medical Association and other doctor groups sharply criticized the proposed rule CMS published in July, which contained the same pay cut, and have taken their case to Congress that Medicare fees for physicians should not be reduced.

11/02/23

ALEX KACIK  
ALISON BENNETT  

Providers participating in the 340B drug discount program will receive approximately $9 billion to compensate them for reductions in previous years under a final rule the Health and Human Services Department and the Centers for Medicare and Medicaid Services published Thursday.

CMS will distribute the money in lump sums to eligible providers to undo reimbursement cuts from 2018 to 2022, which the Supreme Court ruled invalid last year. About 1,700 hospitals are due to receive funds by Jan. 1. But because federal law requires this spending to be budget-neutral, CMS offset the cost by reducing reimbursements for other outpatient products and services by $7.8 billion.

October 16, 2023

ALEX KACIK 

More than 145,000 healthcare practitioners left the industry from 2021 through 2022, threatening access and quality, according to a report published Monday.

Physicians accounted for roughly half of the healthcare workers who retired or changed professions over the two-year span, according to an analysis of all-payer claims data from Definitive Healthcare, a healthcare commercial intelligence company. More than 71,000 physicians left the workforce from 2021 to 2022.

October 11, 2023

CAROLINE HUDSON 

Envision Healthcare plans to emerge from Chapter 11 bankruptcy this month, the physician staffing company announced Wednesday.

The U.S. Bankruptcy Court for the Southern District of Texas approved a reorganization plan for Envision Healthcare that will eliminate 70% of its funded debt. The for-profit company expects to finalize the transaction within weeks, according to a news release.