Medicaid

GAO Sees Mixed Results In Coordination Of High-Risk Medicaid Patients | 9/17/2019

GAO Sees Mixed Results In Coordination Of High-Risk Medicaid Patients By James Romoser 10 PM State efforts to manage the costs of care for high-expenditure Medicaid beneficiaries have had mixed results, and the most significant barriers to better care management are difficulties dealing with social determinants of health, shortages of providers in rural areas and an inability to contact some beneficiaries, the Government Accountability Office says in a …

Medicaid not as lucrative for hospitals since ObamaCare, millions of poor were shifted to private insurance. Recent hospital closures in West Virginia and Ohio blamed in part on “slow Medicaid reimbursements”-Naomi Spencer, wsws.org | 9/16/2019

Fueling the profit drive has been the deterioration of Medicaid reimbursement rates with the imposition of the Obama-era “Affordable Care Act, ” which shifted millions of poor Medicaid recipients into the private health insurance industry . … The hospital administration [Alecto] pointed to slow Medicaid reimbursements and payments from the state for creating the financial crisis.” 9/16/19, “ Abrupt closures of two hospitals in West Virginia and Ohio leave region reeling, “ Naomi Spencer …

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GAO: Staff shortages, social factors barriers to treating high-cost Medicaid beneficiaries | FierceHealthcare | 9/16/2019

RELATED: Medicaid managed care executives say plans must tackle social determinants, opioids GAO reached out to seven states — Indiana, Nevada, Pennsylvania, South Carolina, South Dakota, Vermont and Washington — that were able to identify and predict high-cost beneficiaries through statistics and risk scores. The GAO also spoke with five managed care organizations. Each of the states told GAO they used care management, which coordinates care across different providers, to rein …

AHA: Proposed CMS Rule Hinders Medicaid Reimbursements | HealthPayer Intelligence | 9/16/2019

Public Payers News AHA: Proposed CMS Rule Hinders Medicaid Reimbursements CMS should consult more stakeholders before enacting the rule that could limit providers’ ability to ensure sufficient Medicaid reimbursements, AHA says. Source: Thinkstock By September 16, 2019 - American Hospital Association (AHA) is concerned that the recent CMS proposal to relax the 2015 mandatory Medicaid access monitoring review plans will limit providers’ ability to confront Medicaid reimbursement failures and remove needed …

Provider Shortages and Limited Availability of Behavioral Health Services in New Mexico’s Medicaid Managed Care Report (OEI-02-17-00490) 9-12-2019 | 9/16/2019

Provider Shortages and Limited Availability of Behavioral Health Services in New Mexico’s Medicaid Managed Care 09-12-2019 Report (OEI-02-17-00490) Complete Report WHY WE DID THIS STUDY Medicaid plays a critical role in providing behavioral healthcare. Nationally, Medicaid is the single largest payor for behavioral healthcare. In addition, Medicaid enrollees experience a higher rate of behavioral health disorders-which includes both mental health disorders and substance use disorders-than the general …

Exclusive: Trillium Badgers Hospitals In Fight For Lucrative Portland-Area Medicaid Market | 9/16/2019

… or the contract puts an unreasonable financial, administrative or other burden on the provider. For-profit Trillium, a subsidiary of insurance giant Centene Corp., has thumped the three major hospital systems – Providence Health & Services, Legacy Health and Oregon Health & Science University – with the rules. CEO Chris Hummer also warned all three in letters that “concerted refusal” by “dominant” health care providers to sign contracts may violate state and federal antitrust …

States focus on high-risk patients to drop Medicaid spending | 9/16/2019

16 States focus on high-risk patients to drop Medicaid spending Modern Healthcare: States have mixed results when coordinating patient care and addressing the social determinants of health to manage healthcare costs for high-cost Medicaid beneficiaries, according to a new Government Accountability Office report released Thursday.The GAO found that all the states surveyed offered care management assistance to providers to better manage physical and mental health conditions for fee …

OCPA: Medicaid Won’t Reduce Inflated Hospital Bills | 9/16/2019

OCPA: Medicaid Won’t Reduce Inflated Hospital Bills By Jonathan Small Most of us have heard of someone who received a wildly implausible bill from a hospital. Among the examples compiled by the website, thehealthy.com , were hospitals that charged $15 per Tylenol tablet, $8 for a “mucus recovery system” (better known as a box of tissues), $53 per non-sterile pair of gloves, $10 for the little plastic cup that holds …

EDITORIAL: Tell federal regulators to reject Idaho’s work requirements for Medicaid expansion - InsuranceNewsNet | 9/15/2019

EDITORIAL: Tell federal regulators to reject Idaho’s work requirements for Medicaid expansion Idaho Statesman (Boise) –Federal regulators should shoot down, deny, decline and otherwise reject the Idaho Legislature’s wish to add a “work requirement” to Medicaid expansion. Idaho’s voters didn’t vote for a work requirement when they passed, with 61 percent support, Medicaid expansion for those who fall in the coverage gap, the tens of thousands of people who make …

DOJ MIED: $150 Million Medicare Fraud In Michigan, What about Medicaid Fraud In Child Welfare | 9/15/2019

… tarmack at night… As the feds have now demonstrated a basic understanding of stealin’, I await actions of the Child Welfare System. $150 million is but a drop in the bucket when dealing with Medicaid Fraud in Child Welfare. Nursing home mogul Philip Esformes sentenced to 20 years for $1.3 billion Medicaid fraud I believe we shall start seeing significant movement as we are entering the 2020 campaign season. Michigan …

Letters to the Editor: Saving Medicaid is a bizarre reason to reject Medicare for all - Los Angeles Times | LA Times | 9/14/2019

To the editor: Sara Rosenbaum and Stephen Warnke pile on the fear campaign against Medicare for all by saying adopting a single-payer healthcare system would imperil Medicaid . These authors know that single-payer Medicare for all is not simply existing Medicare with enrollment expanded to all. Current Medicare has important coverage gaps and enrollment obstacles. Everything Medicaid does now, single payer will do better. Retroactive coverage and quick uptake …

Study: More than Half a Million Enrolled in Medicaid in Nine States Are Ineligible - Tennessee Star | 9/14/2019

1 by Bethany Blankley More than 500,000 people enrolled in Medicaid through expansion in nine states though their income made them ineligible for the program, a new stud y published by the National Bureau of Economic Research (NBER) found. Co-authored by professors at the University of Kentucky and Georgia State University, the analysis notes that the nine states evaluated represent only 25 percent of the 37 states that expanded …

Arkansas fines firm $300,000 for Medicaid ride failures | 9/14/2019

Print By - Associated Press LITTLE ROCK, Ark. (AP) - Months after the state of Arkansas fired a company for failing to provide required rides to Medicaid patients, the company hired in its place is being fined more than $300,000 for the same violation. Janet Mann, director of the state Department of Human Services’ Division of Medical Services , told lawmakers earlier this week that Atlanta-based Southeastrans was fined $500 for each …

Arkansas fines firm $300,000 for Medicaid ride failures | ArkLaTexHomepage | 9/14/2019

Sep 14, 2019 / 08:51 AM CDT / Updated: Sep 14, 2019 / 08:51 AM CDT LITTLE ROCK, Ark. (AP) — Months after the state of Arkansas fired a company for failing to provide required rides to Medicaid patients, the company hired in its place is being fined more than $300,000 for the same violation. Janet Mann, director of the state Department of Human Services’ Division of Medical Services, told lawmakers earlier this week …

Arkansas fines firm $300,000 for Medicaid ride failures - The Edwardsville Intelligencer | 9/14/2019

Arkansas fines firm $300,000 for Medicaid ride failures Updated 8:31 am CDT, Saturday, September 14, 2019 LITTLE ROCK, Ark. (AP) — Months after the state of Arkansas fired a company for failing to provide required rides to Medicaid patients, the company hired in its place is being fined more than $300,000 for the same violation. Janet Mann, director of the state Department of Human Services’ Division of Medical Services, told lawmakers …

Arkansas fines firm $300,000 for Medicaid ride failures - Westport News | 9/14/2019

Arkansas fines firm $300,000 for Medicaid ride failures Updated 9:31 am EDT, Saturday, September 14, 2019 LITTLE ROCK, Ark. (AP) — Months after the state of Arkansas fired a company for failing to provide required rides to Medicaid patients, the company hired in its place is being fined more than $300,000 for the same violation. Janet Mann, director of the state Department of Human Services’ Division of Medical Services, told lawmakers …

Arkansas fines firm $300,000 for Medicaid ride failures | KTVE - myarklamiss.com | 9/14/2019

Sep 14, 2019 / 08:48 AM GMT-0500 / Updated: Sep 14, 2019 / 08:55 AM GMT-0500 LITTLE ROCK, Ark. (AP) — (9/14/19) Months after the state of Arkansas fired a company for failing to provide required rides to Medicaid patients, the company hired in its place is being fined more than $300,000 for the same violation. Janet Mann, director of the state Department of Human Services’ Division of Medical Services, told lawmakers …

Hospital lawsuits target insured, Medicaid patients | 9/13/2019

Hospital lawsuits target insured, Medicaid patients September 12, 2019 by Ray Carter Hospitals in Oklahoma and across the nation have come under fire for filing lawsuits against patients for unpaid medical bills. In Oklahoma, hospital officials have suggested that expanding Medicaid to include able-bodied adults would significantly reduce such patient lawsuits. “Hospitals treat patients in medical emergencies before asking any questions about payment or insurance coverage, as required by …

GAO report on high-cost Medicaid beneficiaries | Modern Healthcare | 9/13/2019

… beneficiaries for a fixed payment. Many of the states used other strategies to control expenditures for high-cost beneficiaries such as case managers, mandatory care management services for particular fee-for-service beneficiaries and home health programs. But these efforts have had inconsistent results. While some states reported that they’d experienced a decrease in care costs and utilization for their high-expenditure beneficiaries, others said their findings were mixed or …

Democratic debate live stream: How, when to watch the next Democratic presidential debate on ABC | 9/13/2019

… rebuttals. Candidates will have the opportunity to deliver opening statements, but there will be no closing statements.Here’s a look at all the candidates in the race for the Democratic nomination (in alphabetical order): Sen. Michael Bennet The senior senator from Colorado announced his presidential bid during a May 2 appearance on CBS This Morning , just weeks after a successful prostate cancer operation.Bennet said his ability to win over Republican constituents …

Medicare

Letters to the Editor: Saving Medicaid is a bizarre reason to reject Medicare for all - Los Angeles Times | LA Times | 9/14/2019

To the editor: Sara Rosenbaum and Stephen Warnke pile on the fear campaign against Medicare for all by saying adopting a single-payer healthcare system would imperil Medicaid . These authors know that single-payer Medicare for all is not simply existing Medicare with enrollment expanded to all. Current Medicare has important coverage gaps and enrollment obstacles. Everything Medicaid does now, single payer will do better. Retroactive coverage and quick uptake …

Top Health and Aging Organizations Kick Off National Medicare Education Week with Free Events and Resources to Help Simplify Medicare Enrollment | Business Wire | 9/10/2019

MINNETONKA, Minn.–(BUSINESS WIRE)–Sep 10, 2019– To help simplify the process of learning about Medicare, Medicare beneficiaries, their families and caregivers are invited to attend free Medicare events and online webinars during National Medicare … of health benefit programs for individuals, employers, and Medicare and Medicaid beneficiaries, and contracts directly with more than 1.3 million physicians and care professionals, and 6,000 hospitals and other care facilities nationwide. The company also

ACA

Study: More than Half a Million Enrolled in Medicaid in Nine States Are Ineligible - Tennessee Star | 9/14/2019

1 by Bethany Blankley More than 500,000 people enrolled in Medicaid through expansion in nine states though their income made them ineligible for the program, a new stud y published by the National Bureau of … were essentially non-existent prior to the implementation of the ACA in 2014.” They then compared data from nine states that fully expanded Medicaid with data from 12 states that had not expanded Medicaid by

AMA

AMA report: Insurers should follow Medicaid’s lead in mitigating opioid epidemic | FierceHealthcare | 9/9/2019

Health insurers looking to do more to address the opioid epidemic should look to what’s working in Medicaid, according to a new report from the American Medical Association (AMA) and consulting firm Manatt Health. The two organizations joined forces to release a new national road map that examines state-level efforts to tackle the opioid crisis. One of the key themes that emerged from the research—which focused in four …

Amanda Parsons, M.D., Appointed Deputy Chief Medical Officer of MetroPlus Health Plan | Business Wire | 9/9/2019

NEW YORK- MetroPlus Health Plan today announced the appointment of Amanda Parsons, M.D., as the health plan’s new Deputy Chief Medical Officer (DCMO). Dr. Parson’s assumed her new position on September 3. “I am pleased … New Yorkers a wide selection of health insurance options, including Medicaid, Medicare, Child Health Plus, MetroPlus Gold for city employees and SHOP for small businesses. The health plan offers access to primary, specialty, pharmacy and

Medicare Advantage

Top Health and Aging Organizations Kick Off National Medicare Education Week with Free Events and Resources to Help Simplify Medicare Enrollment | Business Wire | 9/10/2019

… providers. In the United States, UnitedHealthcare offers the full spectrum of health benefit programs for individuals, employers, and Medicare and Medicaid beneficiaries, and contracts directly with more than 1.3 million physicians and care professionals, and … UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract. Enrollment in the plan depends on the plan’s contract renewal with Medicare. Fitbit and the Fitbit logo are …

The Advisory Board’s Christopher Kearns Looks at the Massive Complexity of the “One Foot” Situation | 9/9/2019

Medicare Advantage, Medicaid, and commercial reimbursement, what percentage of payments are in each category? It’s still shockingly low in terms of risk-based payment, overall. Original Medicare does have a ton of pay-for-performance elements in it; but in terms of overall payment, it’s still very low. Meanwhile, only 1.7 percent of commercial payment is population-based, meaning capitated or the equivalent thereof. And it’s only 10.3 percent even …

Department of Health and Human Services

Medicaid expansion trends are emerging in Maine. Here’s how they’re bucking expectations. | 9/11/2019

Medicaid expansion trends are emerging in Maine. Here’s how they’re bucking expectations. Robert F. Bukaty AP Robert F. Bukaty AP Governor Janet Mills speaks at a news conference in the State House with Department of Health and Human Services Commissioner Jeanne Lambrew at right. The department has enrolled more than 36,000 people in Medicaid as a result of expansion under the Affordable Care Act in eight months. By Caitlin Andrews …

New Timeline for Medicaid Transformation | 9/11/2019

Medicaid Transformation September 11th, 2019 By Kerri Erb, Chief Program Officer, and Jennifer Editor’s note: This is an update to information posted July 16, 2019. The managed-care rollout has been changed to one phase for the whole state in February 2020, rather than starting in November 2019 with some counties . Open enrollment is now scheduled to end on Dec ember 13 for all counties . The NC Department of Health …

Behavioral Health

How Will Medicare-for-all Proposals Affect Medicaid? | The Henry J. Kaiser Family Foundation | 9/12/2019

… private insurance and Medicare, the debate has largely ignored the effects on the low-income and vulnerable populations covered by Medicaid and the broader implications for states of eliminating the Medicaid program . Key changes related … for vulnerable populations that includes a wide range of medical, behavioral health, and long-term care benefits. It also is the largest source of federal funds to states. This issue brief explores key ways in …

Medicaid billing currently unavailable for some professional counselors | 9/12/2019

There’s been a change to Medicaid and it could be affecting your school-aged children. Earlier this year, the Louisiana Department of Health says it was made aware of a change effective July 1, 2019 … counselors and fully rely on non-profit agencies to provide behavioral health services. Some schools don’t have enough counselors to fill the need. LPC’s working for FQHC’s have been able to bill Medicaid and receive

Mental Health

Rural Missouri needs Medicaid expansion | 9/9/2019

… mental health, maternity and hospitalization. But my patients are still struggling to afford or access the care they need. That’s why Missouri should pass Medicaid expansion. Missouri politicians are leaving behind many low-income families and workers by refusing to expand Medicaid in our state, costing them not only their hard-earned money but their health, and even in some cases their lives. A new working paper published by the …

Kaiser Family Foundation

Community health centers implore Congress to extend $4B fund | Crain’s New York Business | 9/9/2019

… a third. All the while, health center leaders and advocates, along with the authors of a new report from the Kaiser Family Foundation, point to alarming contingency plans and fallout should the extension be delayed … may see a reduction in patients who are covered by Medicaid. “It’s really critical that health centers still have the capacity to see every patient that comes through their door,” she said. Robert Hayes, president …

Redefining “Career” For Today | Forbes | 9/9/2019

Medicaid accounting for most of other half, according to Kaiser Family Foundation. Employers automatically deduct our payroll taxes, provide training and development, and help subsidize our retirement. Put simply, we have historically depended on employers for a great number of things. Employers provide structure, stability, and consistency to our daily lives. So it makes sense that we tend to see our careers as a sequential list of employers. Just look …

ACO

CMS extends ACO patient notification deadline to Oct. 1 | FierceHealthcare | 9/4/2019

The Trump administration extended a deadline to Oct. 1 for accountable care organizations to notify beneficiaries they are in an ACO. The decision announced last week by the Centers for Medicare & Medicaid Services applies for ACOs whose performance years started on July 1 under the new “Pathways to Success” program. ACOs had complained to the agency that the requirement was confusing and had a short turnaround time. CMS at first …

Missouri Becomes Latest State to Deploy Eccovia’s Cloud-Based ClientTrack Platform to Manage Statewide Refugee Resettlement Programs | Business Wire | 9/4/2019

ACO/MCOs, Medicaid Waiver programs, community-based providers, and other human service entities. Our platform helps caseworkers and care providers collaborate across the spectrum of service delivery to address the physical, behavioral, and economic factors that impact health outcomes. About MO-ORA: MO-ORA provides administration and oversight for many Office of Refugee Resettlement (ORR)-funded programs in the State of Missouri. As a division within the International Institute of …

Home Health

GAO report on high-cost Medicaid beneficiaries | Modern Healthcare | 9/13/2019

… mixed results when coordinating patient care and addressing the social determinants of health to manage healthcare costs for high-cost Medicaid beneficiaries, according to a new Government Accountability Office report released Thursday. The GAO found … care management services for particular fee-for-service beneficiaries and home health programs. But these efforts have had inconsistent results. While some states reported that they’d experienced a decrease in care costs and utilization for …

The Centers for Medicare & Medicaid Services Could Use Comprehensive Error Rate Testing Data To Identify High-Risk Home Health Agencies Audit (A-05-17-00035) 09-05-2019 | 9/10/2019

The Centers for Medicare & Medicaid Services Could Use Comprehensive Error Rate Testing Data To Identify High-Risk Home Health Agencies 09-05-2019 Audit (A-05-17-00035) Complete Report CMS could use Comprehensive Error Rate Testing (CERT) data to identify high-risk home health agencies (HHAs) as a part of a multifaceted approach that includes targeted probe-and-educate reviews as well as aspects of its Fraud Prevention System to further reduce improper …

UnitedHealth

Medicaid Kentucky Market CFO - Louisville, KY - RELOCATION AVAILABLE - UnitedHealth Group - Louisville, KY | 9/10/2019

… Work side-by side with the Business Team and/or Finance personnel within OptumHealth and/or across other aspects of UnitedHealth Group, to fully understand the business and support the financial goals and objectives Develop … degree in Finance or equivalent field 3 plus years of Medicaid Finance experience 8+ years broad experience in multiple Finance disciplines Advanced knowledge of Health Care industry Experience reporting to Executive Leadership in a strategic …

Nurse Practitioner Traveler Institutional Sign On Bonus and Loan Repayment for External Candidates and Eligible Employees - UnitedHealth Group - Hudson County, NJ | 9/9/2019

Medicaid patients, Optum is the nation’s largest health and wellness business and a vibrant, growing member of the UnitedHealth Group family. We’re also the career home for Nurse Practitioners who bring compassion and passion, energy and focus to their work every day. If you want more meaning in your career - as a clinician or a business professional - take this opportunity and apply. It’s the first step in a new career …

UnitedHealth Group

Medicaid Rebate Director - Sacramento, CA - UnitedHealth Group - Sacramento, CA | 9/12/2019

Share Description The Medicaid Rebate Director is responsible for the management of all aspects of the state Medicaid program’s Federal and Supplemental rebate programs and OptumRx’s compliance with all contractual requirements related to rebates. In … and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order

Top Health and Aging Organizations Kick Off National Medicare Education Week with Free Events and Resources to Help Simplify Medicare Enrollment | Business Wire | 9/10/2019

Medicaid beneficiaries, and contracts directly with more than 1.3 million physicians and care professionals, and 6,000 hospitals and other care facilities nationwide. The company also provides health benefits and delivers care to people through owned and operated health care facilities in South America. UnitedHealthcare is one of the businesses of UnitedHealth Group (NYSE: UNH), a diversified health care company. For more information, visit UnitedHealthcare at www.uhc.com or follow @UHC on …

CVS Health

The Health 202: Michigan ban highlights threat of flavored e-cigarettes to young people | The Washington Post | 9/4/2019

CVS Health announced yesterday it would invest $50 million toward reducing youth e-cigarette use. Five years ago, the pharmacy pulled tobacco products from its stores and will include smoking cessation programs through Medicaid plans, including through Aetna’s managed Medicaid plans, according to a news release. “Unfortunately, the trend of tobacco use is increasing among Medicaid recipients, and while many people want to quit, we understand how hard that can …

CVS moving to change healthcare: A timeline since the Aetna acquisition | Becker’s Hospital Review | 8/29/2019

Since buying health insurer Aetna in November, CVS Health has emphasized holistic healthcare rather than just selling medicine. The company said it hopes its strategic shift will lead to healthier communities and lower healthcare costs … Unite Us, a social care coordination platform, to help Aetna’s Medicaid and dual-eligible Medicaid and Medicare members more easily access social services in their communities. Under the program, eligible members will be able to

CVS

PBM startup Capital Rx launches new ‘clearinghouse’ drug pricing model | FierceHealthcare | 9/3/2019

… at the pharmacy for a drug, and pocket the difference. RELATED: Senators ask OIG to investigate PBM spread pricing in Medicaid The clearinghouse approach also aims to bring more light to both employers and pharmacies … several big names in the PBM space, including UnitedHealth and CVS Caremark , have embraced passthrough discounts over rebates. Capital Rx’s plans are attracting investors, too. In July, the PBM secured a $12 million funding round …

Trump’s Health Team Making It Tough On ‘Medicare For All’ | Forbes | 9/1/2019

… private Medicare Advantage coverage through technology upgrades and added benefits to such plans. Just last week, the Centers for Medicare & Medicaid Services rolled out a new “Plan Finder” and highlighted a lot of the private … more health insurers including Anthem, Cigna, Humana, UnitedHealth Group and CVS Health’s Aetna insurance business, are signing up record numbers of seniors to Medicare Advantage and offering such coverage in new regions for next year …

Optum

UnitedHealthcare and Optum Take Action to Support People in Carolinas and Georgia Preparing for Hurricane Dorian | Business Wire | 9/1/2019

ATLANTA- UnitedHealthcare and Optum, the health benefits and services companies of UnitedHealth Group (NYSE: UNH), are taking action to help people in the Carolinas and Georgia who may be affected by Hurricane Dorian. This is … the local time zone), Monday through Friday. People enrolled in Medicaid, employer-sponsored and individual health plans (except Medicare) who have a smartphone can download the free Health4Me app , which provides instant access to their

UnitedHealthcare and Optum Take Action to Support People in Carolinas and Georgia Preparing for Hurricane Dorian – Company Announcement - FT.com | Financial Times | 9/1/2019

… UnitedHealthcare plan participants whose access to care or prescriptions needs may have been affected Free emotional-support help line from Optum open to anyone ATLANTA –(BUSINESS WIRE)–Aug. 31, 2019– UnitedHealthcare and Optum, the health … the local time zone), Monday through Friday. People enrolled in Medicaid , employer-sponsored and individual health plans (except Medicare ) who have a smartphone can download the free Health4Me app , which provides instant access to their …

Purdue Pharma

Virginia Democrats bet on Obamacare to win statehouse - POLITICO | 9/4/2019

… the mid-term blue wave. This November will be the first time state lawmakers face voters since Virginia adopted Obamacare’s Medicaid expansion, which has covered over 300,000 low-income residents since enrollment began last November … already grabbed the http://healthcareitpolicy.com landing page. What We’re Reading Purdue Pharma is gearing up to seek bankruptcy protection before the end of September if it doesn’t reach a settlement over lawsuits alleging the company …

Brooklyn doctors create accountable care organization to build on DSRIP work | Crain’s New York Business | 9/3/2019

… Brooklyn Independent Practice Association has become a state Department of Health-certified accountable care organization. The Centers for Medicare and Medicaid Services has also approved the ACO to participate in its Medicare Shared Savings Program … potential $10 billion to $12 billion settlement with opioid maker Purdue Pharma, The Wall Street Journal reported . One of their concerns is the settlement’s reliance on future sales on drugs that have proven destructive to …

Anthem, Inc.

(USA-IN-Indianapolis) Health Program Representative I - Waukesha, WI - PS24712 | 9/6/2019

Anthem, Inc Health Program Representative I - Waukesha, WI - PS24712 Health Program Representative I - Waukesha, WI - PS24712 Location: United States Requisition : PS27284 Post Date: 1 day ago Your Talent. Our Vision. At Amerigroup , a proud member of the Anthem, Inc. family of companies focused on serving Medicaid, Medicare and uninsured individuals, it’s a powerful combination. It’s the foundation upon which we’re creating greater access to care for our members, greater value …

Healthcare providers save time and costs with new integrated product from AIM Specialty Health | Business Wire | 8/27/2019

… AIM Inform to complete prior authorizations for high-tech, diagnostic imaging services and comply with the Centers for Medicare and Medicaid Services 2020 mandate to use Appropriate Use Criteria. AIM Inform , a solution from AIM … and their patients. AIM is a wholly-owned subsidiary of Anthem, Inc. (ANTM). For more information, visit www.aimspecialtyhealth.com and www.aiminform.com . View source version on businesswire.com : https://www.businesswire.com/news/home/20190827005638/en/ CONTACT: Lori McLaughlin KEYWORD …

Express Scripts

Zacks Industry Outlook Highlights: Joint, Anthem, Centene and UnitedHealth | 8/8/2019

… plans can be availed by ways such as private purchase, social insurance or social welfare programs such as Medicare and Medicaid, funded by the government. Let us take a look at the industry’s three major … with CVS Health Corp. (CVS) and Cigna Corp. (CI) with Express Scripts are the best examples of inter industry deals that led to the union of a health insurer and a pharmacy benefit manager. • The …

Outlook for Health Insurance Industry Looks Sanguine - August 7, 2019 - Zacks.com | 8/7/2019

… plans can be availed by ways such as private purchase, social insurance or social welfare programs such as Medicare and Medicaid, funded by the government. Let us take a look at the industry’s three major … CVS - Free Report ) and Cigna Corp. ( CI - Free Report ) with Express Scripts are the best examples of inter industry deals that led to the union of a health insurer and a pharmacy benefit manager. • The …

Novartis

First Edition: August 27, 2019 | Kaiser Health News | 8/27/2019

… or entry visas to applicants who use — or are deemed likely to use — federally funded food stamps, housing assistance and Medicaid. (Ibarra, 8/27) The New York Times: Johnson & Johnson Ordered To Pay $572 Million In … sidewalks — for decades. (Scattergood, 8/26) Stat: FDA Report: Agency Believed Novartis Data Problem Was Already Resolved Shortly before serious data problems surfaced in mid-March at a troubled Novartis (NVS) unit, a Food and Drug …

First Edition: August 26, 2019 | Kaiser Health News | 8/26/2019

… crippling air ambulance bills that can top $100,000 per flight. The state’s unexpected solution? Undercut the free market by using Medicaid to treat air ambulances like a public utility. The issue has come to a … It’s been just over a month since Amgen (AMGN) and Novartis (NVS) ended two studies of an experimental Alzheimer’s treatment early, the latest in a long string of failures in Alzheimer’s drug development. There is …

Apple Health

Wednesday, August 21, 2019 | Kaiser Health News | 8/21/2019

… the federal government Tuesday over new Trump administration rules blocking green cards for many immigrants who use public assistance including Medicaid, food stamps and housing vouchers. The states and city join a growing list of … benefits manager Express Scripts Holding Co last year. (8/20) CNBC: Apple Health Employee Departures Show Split Over Ambitions Apple’s health team has seen a slew of departures in the past year after a series of …

Why telehealth isn’t in nursing homes - POLITICO | 8/21/2019

… problems in two struggling projects: the VA’s attempt to bring scheduling software to the system, and the repository for national Medicaid data. But first, the jump: eHealth tweet of the day: GomerBlog @GomerBlog “BREAKING: Once … Washington University’s school of public health. A What We’re Reading Apple Health team running into tensions, CNBC reports . An editorial in Nature Digital Medicine unearths an “inconvenient truth” in AI in health care. Kaiser Health …

Goldman Sachs

Zocdoc’s new pricing rankles New York doctors | Crain’s New York Business | 8/27/2019

… since its 2007 founding has raised $223 million from such investors as Salesforce CEO Marc Benioff, Amazon CEO Jeff Bezos, Goldman Sachs and Khosla Ventures. Related Article Zocdoc’s CEO thinks you should be able to … It has blocked users who say they are Medicare or Medicaid beneficiaries from booking visits through its site. But it is looking for a way to restore access to those users. “For over a year …

Morgan Stanley

Evolent Health to Participate in Upcoming Investor Conferences | PR Newswire | 8/22/2019

… on Thursday, September 5, 2019 at 9:05 a.m. EST . Mr. Blackley, Mr. Johnson and Mr. McGrane will present at the Morgan Stanley 2019 Global Healthcare Conference in New York on Tuesday, September 10, 2019 at … 35 health care organizations to actively manage care across Medicare, Medicaid, commercial and self-funded adult and pediatric populations. With the experience to drive change, Evolent confidently stands by a commitment to achieve results. For …

Sarepta Therapeutics, Inc. (SRPT) CEO Douglas Ingram on Q2 2019 Results - Earnings Call Transcript | Seeking Alpha | 8/8/2019

… as soon as possible following approval. We expect commercial plans to provide faster access and government payers, such as state Medicaid plans. But both types of payers will follow normal new drug approval or new … Operator And our next question comes from Matthew Harrison with Morgan Stanley. You may proceed. Unidentified Analyst Hi, this is Max Score (ph) on for Matthew Harrison. Regarding the PPMO Program, could you talk about …

SVB Leerink

Sarepta Therapeutics, Inc. (SRPT) CEO Douglas Ingram on Q2 2019 Results - Earnings Call Transcript | Seeking Alpha | 8/8/2019

… Bernstein Brian Skorney - Robert W. Baird Danielle Brill - Piper Jaffray Timothy Lugo - William Blair Ross Weinreb - Goldman Sachs Joseph Schwartz - SVB Leerink Timothy Chiang - BTIG Liisa Bayko - JMP Securities Operator Good day, ladies and gentlemen … to provide faster access and government payers, such as state Medicaid plans. But both types of payers will follow normal new drug approval or new NDC processes for each plan by stage. We also expect …

Bio-Techne Corp (TECH) Q4 2019 Earnings Call Transcript - Nasdaq.com | 8/7/2019

… our patented technology platform. We have contracted with 26 commercial health plans and PPO networks and have enrolled coverage by Medicaid in 34 states. That’s an amazing amount of progress to what is essentially a … will take our first question today from Puneet Souda with SVB Leerink. Please go ahead, sir. Puneet Souda – SVB Leerink – Analyst Yeah. Hi, Chuck and Jim. Thank you for taking the questions. So, first one …

Citigroup

Evolent Health, Inc. (EVH) CEO Frank Williams on Q2 2019 Results - Earnings Call Transcript | Seeking Alpha | 8/7/2019

… Gillmor - Robert W. Baird & Co. Richard Close - Canaccord Genuity Corp. Mohan Naidu - Oppenheimer Charles Rhyee - Cowen and Company Stephanie Demko - Citigroup Operator Welcome to Evolent Health Earnings Conference Call for the quarter ended June 30 … strong momentum in the core markets that we serve. In Medicaid and Medicare, the administration’s actions demonstrate a core commitment to moving the market to value-based reimbursement. Over the past 9 months, CMS rebound …

Sanofi (SNY) Q2 2019 Earnings Call Transcript - Nasdaq.com | 8/6/2019

… Operator Thank you. Your next question comes from line of Peter Verdult from Citi. Please ask your question. Peter Verdult – Citigroup – Analyst Yes, morning. Peter, here from Citi. Apologies for any background noise. Two questions … one of which appears to remove the pennies rule for Medicaid. Now given the size of a product like Lantus and the ability to have taken prices well over CPI over many, many years, I …

Rock Health

Flare Capital just raised $255 million, and the buzzy VC firm’s cofounder told us he wants to invest in companies trying to reinvent the way we get healthcare in the US | Business Insider | 7/26/2019

… raised its first fund in 2015, investing in companies including Iora, Somatus, the startup insurer Bright Health, the investment firm Rock Health, and the data platform HealthVerity. Read more: A doctor raised more than $250 … invest in companies working to serve sick people in the Medicaid program, as well as in behavioral health, senior care, and end-of-life care. “We are focused on novel solutions for the most expensive …

Digital health investments bounced back in Q2 2019 with nearly $2.5B in funding | MobiHealthNews | 7/5/2019

… GV, Oak HC/FT and Polaris Partners The latest round will support Quartet’s ongoing expansion, with a particular focus on Medicaid beneficiaries who are in need of behavioral health services. Quartet’s integrated platform links providers … digitized bio specimen slides when making a cancer diagnosis. $13.40 Rock Health, Norwich Ventures and Scientific Health Development The startup will be expanding its presence within the Department of Veterans Affairs as well as building …

RBC Capital Markets

Addus HomeCare Announces Closing of Public Offering and Exercise of Option to Purchase Additional Shares | PR Newswire | 9/9/2019

… future acquisitions or investments, and the repayment of indebtedness outstanding under the Company’s amended and restated credit facility. Jefferies LLC, RBC Capital Markets, LLC and Raymond James & Associates, Inc. acted as joint book-running managers … payment structures at the state or federal levels; changes in Medicaid, Medicare, other government program and managed care organizations policies and payment rates; changes in, or our failure to comply with existing, federal and state …

Addus HomeCare Announces Public Offering of Common Stock | PR Newswire | 9/3/2019

… will not receive any proceeds from the sale of the shares of common stock by the Selling Stockholders. Jefferies LLC, RBC Capital Markets, LLC and Raymond James & Associates, Inc. are acting as joint book-running … payment structures at the state or federal levels; changes in Medicaid, Medicare, other government program and managed care organizations policies and payment rates; changes in, or our failure to comply with existing, federal and state …

Oak HC/FT

Oak HC/FT $800 million fund and what it wants to invest in - Business Insider | 8/1/2019

Venture capital firm Oak HC/FT just raised an $800 million fund, bringing its total assets under management to $1.9 billion. It’s the third fund for the firm, which was founded in 2014 and invests … with the new fund around healthcare. Companies that work with Medicaid, the US government-funded program that provides health insurance for low-income Americans. Already, Oak HC/FT has invested in Quartet , which just got

Digital health investments bounced back in Q2 2019 with nearly $2.5B in funding | MobiHealthNews | 7/5/2019

Oak HC/FT and Polaris Partners The latest round will support Quartet’s ongoing expansion, with a particular focus on Medicaid beneficiaries who are in need of behavioral health services. Quartet’s integrated platform links providers, payers and services together in its aim to more effectively deliver mental and primary care. $60 General Atlantic, General Catalyst and others The funding will help PathAI pursue new partnerships and build out its existing and …

F-Prime Capital

Hambrecht Ducera Growth Ventures Leads Series B Round for Buoy Health, Joined by Humana, F-Prime and Optum Ventures | Business & Finance | heraldchronicle.com | Business Wire | 8/15/2019

… its enterprise offering by providing more in-depth navigation for new populations, including the “Baby Boomers” and those covered by Medicaid. “Based on our proprietary MESE™ models, Buoy’s impact relative to the amount of money … the health care system,” said Carl Byers, executive Partner at F-Prime Capital Partners , Fidelity Investments private venture capital firm. About Buoy Health Buoy is a health technology company developed out of the Harvard Innovation …

Digital health investments bounced back in Q2 2019 with nearly $2.5B in funding | MobiHealthNews | 7/5/2019

F-Prime Capital Partners, GV, Oak HC/FT and Polaris Partners The latest round will support Quartet’s ongoing expansion, with a particular focus on Medicaid beneficiaries who are in need of behavioral health services. Quartet’s integrated platform links providers, payers and services together in its aim to more effectively deliver mental and primary care. $60 General Atlantic, General Catalyst and others The funding will help PathAI pursue new partnerships and …

F-Prime Capital Partners

Hambrecht Ducera Growth Ventures Leads Series B Round for Buoy Health, Joined by Humana, F-Prime and Optum Ventures | Business & Finance | heraldchronicle.com | Business Wire | 8/15/2019

… its enterprise offering by providing more in-depth navigation for new populations, including the “Baby Boomers” and those covered by Medicaid. “Based on our proprietary MESE™ models, Buoy’s impact relative to the amount of money … the health care system,” said Carl Byers, executive Partner at F-Prime Capital Partners , Fidelity Investments private venture capital firm. About Buoy Health Buoy is a health technology company developed out of the Harvard Innovation …

Digital health investments bounced back in Q2 2019 with nearly $2.5B in funding | MobiHealthNews | 7/5/2019

F-Prime Capital Partners, GV, Oak HC/FT and Polaris Partners The latest round will support Quartet’s ongoing expansion, with a particular focus on Medicaid beneficiaries who are in need of behavioral health services. Quartet’s integrated platform links providers, payers and services together in its aim to more effectively deliver mental and primary care. $60 General Atlantic, General Catalyst and others The funding will help PathAI pursue new partnerships and …

California Health Care Foundation

What common Medicaid challenges can technology help overcome? | MedCity News | 8/2/2019

The four shared challenges for Medicaid programs identified by the Primed roundtable series were member engagement, data actionability, data exchange and workforce capacity. Post a comment / Aug 1, 2019 at 7:02 PM Shares 1 Medicaid … response to this disconnect, VC firm Village Capital, the nonprofit California Health Care Foundation and healthcare consultancy Speire Healthcare launched a roundtable series called Primed to engage stakeholders from across the healthcare value chain to

California to Repay Loans of Docs Who Take Medicaid Patients | Medscape | 7/11/2019

California to Repay Loans of Docs Who Take Medicaid Patients Ken Terry July 11, 2019 California has launched a program that will repay young doctors’ medical school loans if they agree to carry a caseload … Medicaid payment is 72% of Medicare rates, according to the California Health Care Foundation (CHCF). Unsurprisingly, just 60% of California doctors accept new Medi-Cal patients; in contrast, 77% take new Medicare patients, and 85

HCA

More Patients are Choosing Urgent Care Centers, Creating Challenges and Opportunities for Traditional Healthcare Providers - Industry Analysis by Loyale Healthcare | PRWeb | 8/28/2019

More Patients are Choosing Urgent Care Centers, Creating Challenges and Opportunities for Traditional Healthcare Providers - Industry Analysis by Loyale Healthcare Share Article The high cost of healthcare is driving a transformation in the way Americans … are the patients whose healthcare is covered by Medicare or Medicaid. This group’s use of urgent-care centers continues to grow, accounting for nearly 27% of all visits in 2018. In addition to their lower

AscellaHealth President and CEO Dea Belazi Named to FierceHealthcare’s New Editorial Advisory Council, Provides Insight on Healthcare News and Trends | Business Wire | 8/27/2019

BERWYN, Pa.–(BUSINESS WIRE)–Aug 27, 2019– AscellaHealth , a national Pharmacy Benefit Management (PBM) serving commercial, Medicare and Medicaid segments, is proud to announce that Dea Belazi, PharmD, MPH, president and CEO, AscellaHealth, will join industry luminaries on FierceHealthcare’s inaugural Editorial Advisory Council . FierceHealthcare, which aims to address issues and offer insights on the business of healthcare, has chosen 19 thought leaders from hospitals, insurers, physicians’ offices, ACOs, health IT …

Kaiser Permanente

State Highlights: Street Medicine Team In Atlanta Hits Roads, Bridges To Find Homeless; Nonprofit Helps Underserved Patients ‘Across Whole U.S.’ Not Just Appalachia | Kaiser Health News | 9/9/2019

… School repeatedly called out No. 92, in English and Spanish. Connolly was No. 93. Dental care was dropped from her Medicaid coverage this year, Connolly said, and her plan would not cover eyeglasses to replace … approved new transparency requirements for the state’s dominant health system, Kaiser Permanente. It’s a major win for a prominent health workers union that sponsored the bill amid an ongoing fight with the health system. Each …

Starving Seniors: How America Fails To Feed Its Aging | Kaiser Health News | 9/3/2019

… without steady, nutritious food can wind up in hospitals, which drives up a href=”https://www.ncbi.nlm.nih.gov/pubmed/28608473” Medicare and Medicaid /a costs, a href=”https://www.ncbi.nlm.nih.gov/pubmed/28608473” hitting taxpayers with an even bigger … J. Kaiser Family Foundation /a which is not affiliated with Kaiser Permanente. /p Copy HTML We encourage organizations to republish our content, free of charge. Here’s what we ask: You must credit us as the …

Harvard Medical School

PARTNERS HEALTHCARE TRANSITIONING INTO MEDICARE SHARED SAVINGS PROGRAM | Globe Newswire | 8/22/2019

… GLOBE NEWSWIRE) – Partners HealthCare is now participating in the Medicare Shared Savings Program (MSSP) through the Centers for Medicare and Medicaid Services (CMS). The MSSP Accountable Care Organization (ACO) allows Partners to extend care to … leading biomedical research organizations and a principal teaching affiliate of Harvard Medical School. Partners HealthCare is a non-profit organization. Richard Copp Partners HealthCare 6172781031 [email protected] Related Articles More articles issued by Partners HealthCare …

Hospitals treat patients without admitting them, to avoid penalties | Yahoo News | 8/22/2019

Harvard Medical School in Boston, who led the study. Since 2012, an initiative by the Centers for Medicare and Medicaid Services (CMS) to improve the quality and value of patient care, known as the Hospital Readmissions Reduction Program (HRRP), has imposed financial penalties on hospitals with higher-than-expected rates of readmission within 30 days of discharge for patients initially admitted for heart failure, heart attack or pneumonia. In fiscal …

HCA Healthcare

CMS wants hospitals to post their rates. But hospitals aren’t sure how. | FierceHealthcare | 8/27/2019

… payer rates with little context for the patients who are supposed to benefit from such transparency. The Centers for Medicare & Medicaid Services (CMS) proposed the requirement hospitals post payer-negotiated rates for certain shoppable services … rate at a hospital. For example, UnitedHealthcare may give an HCA Healthcare hospital a good price for a cardiac procedure because they “have great outcomes and get a ton of volume from United,” he added …

Hospitals figure out how to implement CMS transparency requirement | FierceHealthcare | 8/23/2019

… payer rates with little context for the patients who are supposed to benefit from such transparency. The Centers for Medicare & Medicaid Services (CMS) proposed the requirement hospitals post payer-negotiated rates for certain shoppable services … rate at a hospital. For example, UnitedHealthcare may give an HCA Healthcare hospital a good price for a cardiac procedure because they “have great outcomes and get a ton of volume from United,” he added …

UPMC

Medicare Advantage Start-Ups Primed To Disrupt The Status Quo, Warns Cavulus CEO | PR Newswire | 8/28/2019

… have been bolstered by new flexibility in Medicare Advantage plan and benefit design recently permitted by The Centers for Medicare & Medicaid Services (CMS) . Phillips points to benefits such as transportation and in-home care, and … many of America’s top insurers, including several BlueCross/ BlueShield companies, UPMC Health Plan, Johns Hopkins Healthcare, Lumeris and United Healthcare. For details visit: www.cavulus.com . Media Inquiries: 800-760-6915 Email: [email protected] SOURCE Cavulus Related Links http …

14 hospitals closed so far this year — here’s why | Becker’s Hospital Review | 8/19/2019

… Medical Center closed on June 13. The 85-bed hospital abruptly shut down just one day after its Medicare and Medicaid funding was cut off . In a June 7 statement to the Independent Herald , West … declining reimbursements and lower patient volumes. 13. Harrisburg, Pa.-based UPMC Pinnacle closed its hospital in Lancaster, Pa., on Feb. 28. The health system announced plans in December to close UPMC Pinnacle Lancaster and transition …

Mayo Clinic

Paradigm’s Michael Choo, MD Joins External Collaborative Panel of National Limb Loss and Preservation Registry | BioSpace | 9/9/2019

Mayo Clinic, along with oversight from the Department of Veterans Affairs, the Centers for Medicare & Medicaid Services, and the Food & Drug Administration. The registry aims to help patients, healthcare providers, and clinicians better understand the treatment and surgical options for limb preservation and/or amputation. As a first-of-its-kind national registry, it will give researchers access to the largest data set specific to limb loss and amputation care …

Doctor Obamacare Support Grows | Forbes | 9/4/2019

… for the U.S. healthcare system, according to a study of doctor “reactions to ACA implementation” led by researchers of the Mayo Clinic, who wrote a seven-page analysis in the Journal Health Affairs. “A slight … offered on public exchanges as well as the expansion of Medicaid benefits to more poor Americans under the law. Health insurance companies who largely provide the ACA’s health benefits via contracts with the government need …

Community Health, Selinsgrove PA

The Hospital Treated These Patients. Then It Sued Them. | MSN | 8/31/2019

The Hospital Treated These Patients. Then It Sued Them. The New York Times 17 hrs ago Laura Beil PREVIOUS SLIDE SLIDE 1 of 5 NEXT SLIDE Carlsbad Medical Center, in New Mexico, has filed nearly 3,000 lawsuits against patients over unpaid medical debt since 2015. © Cassidy Araiza for The New York Times CARLSBAD, N.M. — The first time Carlsbad Medical Center sued Misti Price, she was newly divorced and working two …

CVS moving to change healthcare: A timeline since the Aetna acquisition | Becker’s Hospital Review | 8/29/2019

Since buying health insurer Aetna in November, CVS Health has emphasized holistic healthcare rather than just selling medicine. The company said it hopes its strategic shift will lead to healthier communities and lower healthcare costs. Below is a timeline of health-related moves from CVS reported by Becker’s Hospital Review since it finalized its deal with Aetna. The timeline doesn’t include the CVS acquisitions of other retail pharmacies. Nov. 28 …

Massachusetts General Hospital

Wentworth-Douglass reduces costs following Mass General merger | 9/9/2019

PORTSMOUTH — Wentworth Douglass Hospital President and CEO Greg Walker said since his hospital merged with Massachusetts General Hospital and its parent company, Partners HealthCare, in 2017 he has observed significant operational cost savings while increasing … because those are some of your high-risk moms; your Medicaid moms, we’ve seen an increase in drug-seeking moms that are delivering babies that are high-risk,” Walker said. “That might not make money

Tuesday, August 27, 2019 | Kaiser Health News | 8/27/2019

… or entry visas to applicants who use — or are deemed likely to use — federally funded food stamps, housing assistance and Medicaid. (Ibarra, 8/27) Seattle Times: Migrant Children Now In Washington State Tell Of Haunting Conditions … after it refused to pay for her $95,000 treatment at Massachusetts General Hospital. The treatment, called proton beam radiation therapy, is designed to precisely target a tumor while protecting the surrounding organs. (Dayal McCluskey, 8/27 …

AHN

Viewpoints: Lessons On Why America Needs Single-Payer Health Care; Medicaid Has Turned Into An Entitlement Program For The Middle Class | Kaiser Health News | 8/15/2019

… and in government programs that, while improved by Obamacare, remain woefully inadequate. (James Downie, 8/14) The Wall Street Journal: ObamaCare’s Medicaid Deception ObamaCare wasn’t supposed to give free health insurance to everybody. The Affordable Care … of big change. What does it all mean? (James G. Kahn and Elliot Marseille, 8/14) The Wall Street Journal: Bernie’s Medicare-For-All Bailout Usually politicians pass a bailout to clean up a mess they’ve …

Hospitals bash immigration rule likely to push millions off Medicaid | Healthcare Dive | 8/13/2019

… Healthcare groups on Monday railed against a Trump administration policy that will make it more difficult for legal immigrants on Medicaid and other public safety net programs to obtain permanent status. The final “public charge … creates a chilling effect, Federation of American Hospitals CEO Chip Kahn said in a statement . “Many eligible people won’t sign up for health insurance coverage, like Medicaid, over fears it could hurt their or their …

Tenet Healthcare

Tenet Healthcare Corporation (THC) CEO Ron Rittenmeyer on Q2 2019 Results - Earnings Call Transcript | Seeking Alpha | 8/6/2019

Tenet Healthcare Corporation (NYSE: THC ) Q2 2019 Results Earnings Conference Call August 2, 2019 10:00 AM ET Company Participants Brendan Strong - VP, IR Ron Rittenmeyer - Executive Chairman & CEO Dan Cancelmi - CFO Conference Call Participants Josh … is related to states where they did not expand their Medicaid programs but that’s nothing new. So now I wouldn’t say there’s anything really unusual? Pito Chickering Thanks so much. Operator We will now take

Four Philadelphia health institutions seek to save St. Christopher’s Hospital for Children | The Business Journals | 7/17/2019

… woes such as obesity, diabetes, and trauma. Two-thirds of the revenue at St. Christopher’s in fiscal 2018 came from Medicaid, the government insurance program for the poor, whereas just 29 percent of CHOP’s revenue … losses in the last two years it was owned by Tenet Healthcare Corp., but had been consistently profitable before that. It has effectively been helping to support operations at Hahnemann in recent years. Tenet sold …

Wellcare

Why Should You Retain WellCare Health in Your Portfolio? - September 10, 2019 - Zacks.com | 9/10/2019

WellCare Health Plans, Inc. ( WCG - Free Report ) is well-poised for growth on the back of rising membership aided by its inorganic growth plans. The company looks well-set for progress, evident from its impressive … companies, will make the combined entity a leader in the Medicaid, Medicare and Health Insurance Marketplace. The company will have a wider scale and diversification with higher Medicaid and Medicare members. The acquisition is expected

Why Is WellCare (WCG) Down 7.3% Since Last Earnings Report? | Zacks | 8/29/2019

… Zacks Equity Research Cancel Read More Hide Full Article A month has gone by since the last earnings report for WellCare Health Plans ( WCG - Free Report ) . Shares have lost about 7.3% in that time frame … was supported by the company’s operating leverage. Q2 Segment Results Medicaid Health Plans As of Jun 30, 2019, membership surged 45.5% to 4.1 million. This upside was driven by the acquisition of Meridian and net …

Aetna

Aetna Medicaid proposes better ways to work with Kansas healthcare providers | News | kansan.com | 9/10/2019

Submitting Letters To The Editor When Aetna became one of the Medicaid providers for Kansas, it did not load the Lawrence Memorial Health contract with the correct rates. Aetna Medicaid is changing the management team for Kansas in hopes to resolve many issues, including delayed payments to healthcare providers Kansan file photo Aetna Medicaid proposes better ways to work with Kansas healthcare providers Lindley Lund @Lindley_Mae98 Save The state …

Trump’s Health Team Making It Tough On ‘Medicare For All’ | Forbes | 9/1/2019

… private Medicare Advantage coverage through technology upgrades and added benefits to such plans. Just last week, the Centers for Medicare & Medicaid Services rolled out a new “Plan Finder” and highlighted a lot of the private … insurers including Anthem, Cigna, Humana, UnitedHealth Group and CVS Health’s Aetna insurance business, are signing up record numbers of seniors to Medicare Advantage and offering such coverage in new regions for next year. “In 2019 …

Humana

Humana (HUM) Ties Up to Boost Medicare Advantage Network | Yahoo News | 9/5/2019

Humana Inc. HUM has entered into a new partnership with Iora Health to add 11 more Iora Primary care practices to its Medicare Advantage network in areas like Texas, Georgia and Arizona. With this deal … which can be accessed by people eligible for Medicare and Medicaid plans along with Original Medicare with or without the most supplement plans and the access to Iora’s care model. Iora is leading the market

Humana (HUM) Ties Up to Boost Medicare Advantage Network - Nasdaq.com | 9/5/2019

Humana (HUM) Ties Up to Boost Medicare Advantage Network September 05, 2019, 11:13:00 AM EDT By Zacks Equity Research, Zacks.com Shutterstock photo Humana Inc. HUM has entered into a new partnership with Iora Health to … which can be accessed by people eligible for Medicare and Medicaid plans along with Original Medicare with or without the most supplement plans and the access to Iora’s care model. Iora is leading the market

Wellcare Health Plans

WellCare Sponsors Support School Meal Kick-Off Event to Address Food Insecurity in Wake County | PR Newswire | 8/22/2019

… the age of 18 live in food-insecure households. To help address food insecurity, WellCare of North Carolina , Inc., a WellCare Health Plans, Inc. (NYSE: WCG ) company, donated $5,000 to the NC Partnership for Child … children, seniors and individuals with complex medical needs primarily through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans, as well as individuals in the Health Insurance Marketplace. WellCare serves approximately 6.3 million members nationwide as …

Centene Expands Existence in Health Insurance Marketplace | Zacks | 8/15/2019

… WellCare Health Plans, Inc. ( WCG - Free Report ) , which is expected to close by the first half of 2020. The combined entity will have a wider scale and diversification with more than 12 million Medicaid and around 5 million Medicare members in its fold. In total, it will have around 22 million members across the 50 US states. All these initiatives poise the company well for long-term growth.Active collaborations and …

UnitedHealthcare

UnitedHealthcare and Optum Take Action to Support People in Carolinas and Georgia Preparing for Hurricane Dorian | Business Wire | 9/1/2019

ATLANTA- UnitedHealthcare and Optum, the health benefits and services companies of UnitedHealth Group (NYSE: UNH), are taking action to help people in the Carolinas and Georgia who may be affected by Hurricane Dorian. This is … the local time zone), Monday through Friday. People enrolled in Medicaid, employer-sponsored and individual health plans (except Medicare) who have a smartphone can download the free Health4Me app , which provides instant access to their

UnitedHealthcare and Optum Take Action to Support People in Carolinas and Georgia Preparing for Hurricane Dorian – Company Announcement - FT.com | Financial Times | 9/1/2019

Assistance for UnitedHealthcare plan participants whose access to care or prescriptions needs may have been affected Free emotional-support help line from Optum open to anyone ATLANTA –(BUSINESS WIRE)–Aug. 31, 2019– UnitedHealthcare and Optum … the local time zone), Monday through Friday. People enrolled in Medicaid , employer-sponsored and individual health plans (except Medicare ) who have a smartphone can download the free Health4Me app , which provides instant access to their

Cigna

Medicare’s New Plan Finder Could Boost Insurers’ Advantage Enrollment | Forbes | 8/27/2019

… boost already fast-growing private Medicare Advantage enrollment. Calling the upgrades the first in a decade, the Centers for Medicare & Medicaid Services (CMS) Tuesday announced a new “Medicare Plan Finder” on the government’s Medicare.gov web … health insurers including Anthem, CVS Health’s Aetna health insurance unit, Cigna, Humana and UnitedHealth Group are expanding sales of Medicare Advantage plans into new states, counties and regions. Meanwhile, several startups and new entrants including …

Readers And Tweeters Take Dialysis Providers To Task: Nowhere But In The USA | Kaiser Health News | 8/23/2019

Cigna. The rest, including Medicare and Medicaid, require two visits. The only benefit is to our practice, which gets $100 for the completely unnecessary second visit. Despite making it clear the single 1,020 mg infusion is just as safe and effective, you halve the number of IVs and chances for minor reactions. It’s not covered, I have no choice. A third get it once; two-thirds, twice. We charge $932 …

Centene Corp

Centene, Aetna protest losing Louisiana MCO contracts worth billions care Finance News | Healthcare Finance | 8/25/2019

The Centene subsidiary, Aetna and three other MCOs were paid $7.6 billion by Medicaid to cover more than 1.7 million beneficiaries. Susan Morse , Senior Editor Aetna and Centene, two insurers on the losing side for … network and Aetna, the report said. The news comes as Centene Corporation announced this month that it is expanding its footprint in the Affordable Care Act marketplace for 2020 in Arizona, Florida, Georgia, Kansas, North

The Individual Market May Have Shrunk, But More And More Insurers Are Banking On Health Law’s Profits | Kaiser Health News | 8/23/2019

… Pennsylvania and Georgia, to its current roster of nine. Insurers including Cigna Corp. , Bright Health Inc., Molina Healthcare Inc. and Centene Corp. , the biggest seller of ACA plans, also plan larger footprints next year. Anthem … received the green light from the Centers for Medicare and Medicaid Services this year to subsidize high-cost claims that fall within a preset dollar amount, ranging from a minimum of $30,000 to a maximum …

AmeriHealth

AmeriHealth Caritas Northeast to Open Community Wellness Center in Hazleton | Business Wire | 8/28/2019

HARRISBURG, Pa.- AmeriHealth Caritas Northeast , a Medicaid managed care plan that serves 22 northeastern Pennsylvania counties, announced today plans to open a community wellness center in Hazleton to help residents overcome the social, economic and environmental barriers to achieving and maintaining a healthy life. The community wellness center will be located at 20 West Broad Street, in a storefront that is the former home of Greater Hazleton Chamber of Commerce …

Amerihealth Caritas

AmeriHealth Caritas Northeast to Open Community Wellness Center in Hazleton | Business Wire | 8/28/2019

HARRISBURG, Pa.- AmeriHealth Caritas Northeast , a Medicaid managed care plan that serves 22 northeastern Pennsylvania counties, announced today plans to open a community wellness center in Hazleton to help residents overcome the social, economic and environmental barriers to achieving and maintaining a healthy life. The community wellness center will be located at 20 West Broad Street, in a storefront that is the former home of Greater Hazleton Chamber of Commerce …

Molina Healthcare

Former Molina CEO named Calif. medical school dean | Modern Healthcare | 8/27/2019

Dr. J. Mario Molina, the former CEO of Medicaid managed care insurer Molina Healthcare, has been named the founding dean of Claremont, Calif.-based Keck Graduate Institute’s new school of medicine. Though it will be several years before the KGI School of Medicine opens its doors to its first class of students, Molina already has big plans to transform medical education to focus on team-based learning while bringing healthcare …

The Individual Market May Have Shrunk, But More And More Insurers Are Banking On Health Law’s Profits | Kaiser Health News | 8/23/2019

… six new states, including Pennsylvania and Georgia, to its current roster of nine. Insurers including Cigna Corp. , Bright Health Inc., Molina Healthcare Inc. and Centene Corp. , the biggest seller of ACA plans, also plan larger … received the green light from the Centers for Medicare and Medicaid Services this year to subsidize high-cost claims that fall within a preset dollar amount, ranging from a minimum of $30,000 to a maximum …

Donald Trump

Missouri GOP Gov. Parson announces 2020 bid to keep his job - news - Suddenlink | 9/9/2019

Donald Trump for president in 2016 and resisted the gains that Democrats made in many other states during last year’s midterm elections. “Missouri families can’t afford four more years of Governor Parson,” Galloway said. She criticized the drop in Medicaid rolls during Parson’s tenure and cited the trend of rural hospitals closing in the state. A cattle rancher and grandfather of six, Parson ran for governor four years ago but …

Missouri GOP Gov. Parson announces 2020 bid to keep his job - news - Cincinnati Bell | 9/9/2019

Donald Trump for president in 2016 and resisted the gains that Democrats made in many other states during last year’s midterm elections. “Missouri families can’t afford four more years of Governor Parson,” Galloway said. She criticized the drop in Medicaid rolls during Parson’s tenure and cited the trend of rural hospitals closing in the state. A cattle rancher and grandfather of six, Parson ran for governor four years ago but …

Seema Verma

CMS launches overhaul of Medicare Plan Finder aimed at improving usability | FierceHealthcare | 8/26/2019

Medicaid Services (CMS) Administrator Seema Verma said on a call with reporters Monday that the updated tool is aimed at empowering consumers with a more individualized experience. “We are pleased to offer a modern, easy-to-use, easy-to-read design, offering a personalized experience,” Verma said. RELATED: As Medicare population booms, MA plans eye growth opportunities, survey finds The updated version of the Plan Finder launched today but will …

Hospitals figure out how to implement CMS transparency requirement | FierceHealthcare | 8/23/2019

… payer rates with little context for the patients who are supposed to benefit from such transparency. The Centers for Medicare & Medicaid Services (CMS) proposed the requirement hospitals post payer-negotiated rates for certain shoppable services … done a great job and put other websites,” CMS Administrator Seema Verma told reporters during a roundtable earlier this month. She mentioned websites made by larger systems such as the Mayo Clinic or Intermountain. But …

Bernie Sanders

How to watch the next Democratic presidential debate on ABC | 9/10/2019

… Buttigieg Former Housing and Urban Development Secretary Julián Castro California Sen. Kamala Harris Former Texas Rep. Beto O’Rourke Vermont Sen. Bernie Sanders Massachusetts Sen. Elizabeth Warren Entrepreneur Andrew Yang The debate format will be one … common ground to get things done.”As governor, he expanded Medicaid to adults making less than about $17,000 per year and garnered support for abortion rights, while many other conservative states lean toward stricter laws.Before …

BREAKING: 2020 Presidential Candidates Tell Us Their Plans to End HIV | 9/9/2019

… President Trump. So far, responses have been returned from several Democratic candidates: Cory Booker, Pete Buttigieg, Kamala Harris, Beto O’Rourke, Bernie Sanders, and Elizabeth Warren. Not surprisingly, many of the candidates’ responses are similar. They … all administration attacks on the Affordable Care Act and on Medicaid, rescinding Trump’ rules that enable LGBTQ discrimination, increasing access to health coverage and addressing cost and other barriers that prevent PrEP access. The Senator …

Joe Biden

Powerful Industry Groups Already Mobilizing To Block Even Most Modest Of 2020 Democrats’ Health Plans | Kaiser Health News | 8/23/2019

… her chief rivals who are poking holes in its specifics and accusing Harris of putting political calculation before true conviction. Joe Biden’s campaign dismisses it as a “have-it-every-which-way” plan while Bernie … the health care message House Democrats used in 2018: expanding Medicaid, protecting Obamacare and slamming Republican repeal efforts. (Ollstein and Arkin, 8/23) And in other 2020 news — Politico: Fact Check: Did Bernie Just Backtrack On …

Friday, August 23, 2019 | Kaiser Health News | 8/23/2019

… her chief rivals who are poking holes in its specifics and accusing Harris of putting political calculation before true conviction. Joe Biden’s campaign dismisses it as a “have-it-every-which-way” plan while Bernie … the health care message House Democrats used in 2018: expanding Medicaid, protecting Obamacare and slamming Republican repeal efforts. (Ollstein and Arkin, 8/23) And in other 2020 news — Politico: Fact Check: Did Bernie Just Backtrack On …

Elizabeth Warren

America, the Gerontocracy - POLITICO Magazine | 9/3/2019

… candidates proposing the most dramatic departure from the status quo are Bernie Sanders, who’ll turn 78 on September 8, and Elizabeth Warren, who’s 70. Still, there’s something to be said for youth and vigor. John … provides medical coverage to elderly people, than it does on Medicaid, which provides medical coverage to poor people. (Another reason for the difference is that the elderly require more health care.) It also may help …

First Edition: September 3, 2019 | Kaiser Health News | 9/3/2019

… in Dayton, Ohio. (9/1) The New York Times: 2020 Democrats Demand Gun Control, But Differ On Tactics Joe Biden and Elizabeth Warren, two of the leading candidates for the 2020 Democratic nomination, made the case … campaigning in pivotal early-voting South Carolina, where lack of Medicaid expansion has left thousands unable to obtain health coverage. The Vermont senator focused on “Medicare for All,” his signature proposal replacing job-based and …

Alex Azar

Kidney transplants: US throwing away 3,500 donated kidneys every year - CNN | 8/26/2019

… of individual programs aiming to provide their patients on waiting lists with the best opportunities.” The Centers for Medicare and Medicaid Services (CMS) has been considering eliminating some regulations that put these transplant programs funds … year on patients with kidney disease. According to HHS Secretary Alex Azar, That is one-fifth of the spending of all Medicare dollars …

Kamala Harris

Sanders: Medicare for All means more taxes, better coverage | Chron | 8/31/2019

… focus of Democratic presidential hopeful Bernie Sanders’ second day of campaigning in pivotal early-voting South Carolina, where lack of Medicaid expansion has left thousands unable to obtain health coverage. The Vermont senator focused on … for pieces of a Medicare for All plan. California Sen. Kamala Harris’ new plan would preserve a role for private insurance. New Jersey Sen. Cory Booker is open to step-by-step approaches. Others including …

Cory Booker

First Edition: August 27, 2019 | Kaiser Health News | 8/27/2019

… or entry visas to applicants who use — or are deemed likely to use — federally funded food stamps, housing assistance and Medicaid. (Ibarra, 8/27) The New York Times: Johnson & Johnson Ordered To Pay $572 Million In … To bring down the rising suicide rate in the U.S., Cory Booker wants to appoint a federal coordinator tasked solely with suicide prevention. Amy Klobuchar wants to fund more local programs designed to prevent suicides …

Healthcare Promises: What 2020 Presidential Candidates Aren’t Telling You | Forbes | 8/26/2019

… four of the 20 Democratic candidates raised their hands during the first round of debates. Mayor Pete Buttigieg and Sen. Cory Booker kept their hands at their sides. Their respective plans can best be described … to build in a public option and expand access to Medicaid , actions that would no-doubt benefit recipients. But he hasn’t acknowledged the elephant in the exam room: If all the government does is increase …

Kirsten Gillibrand

Powerful Industry Groups Already Mobilizing To Block Even Most Modest Of 2020 Democrats’ Health Plans | Kaiser Health News | 8/23/2019

… Theresa Greenfield and Cal Cunningham are staying tightly focused on the health care message House Democrats used in 2018: expanding Medicaid, protecting Obamacare and slamming Republican repeal efforts. (Ollstein and Arkin, 8/23) And in other … Otterbein, 8/22) The Hill: Gillibrand Unveils Mental Health Plan Sen. Kirsten Gillibrand (D-N.Y.) unveiled her plan to improve mental health care in the U.S. this week, arguing that the issue demands more attention from …

Friday, August 23, 2019 | Kaiser Health News | 8/23/2019

… Theresa Greenfield and Cal Cunningham are staying tightly focused on the health care message House Democrats used in 2018: expanding Medicaid, protecting Obamacare and slamming Republican repeal efforts. (Ollstein and Arkin, 8/23) And in other … Otterbein, 8/22) The Hill: Gillibrand Unveils Mental Health Plan Sen. Kirsten Gillibrand (D-N.Y.) unveiled her plan to improve mental health care in the U.S. this week, arguing that the issue demands more attention from …

Steve Bullock

How to watch the next Democratic presidential debate on ABC | 9/10/2019

… common pain that we have all over this country.” RELATED: Things to know about presidential candidate Cory Booker Montana Gov. Steve Bullock Montana Gov. Steve Bullock is most notably known for winning in 2016 as … common ground to get things done.”As governor, he expanded Medicaid to adults making less than about $17,000 per year and garnered support for abortion rights, while many other conservative states lean toward stricter laws.Before …

Campaign 2020: Who are the Democrats running for president and where do they stand on the issues? - South Florida Sun-Sentinel | Chicago Tribune | 8/29/2019

… Obama fast-track power to negotiate a major free trade deal but has not proposed a broader trade agenda.Montana Gov. Steve Bullock talks to reporters after the first of two Democratic presidential primary debates hosted … style weapons and ammunition. Supports universal background checks.Health care: Expanded Medicaid as part of the Affordable Care Act. Won expansion reauthorization from GOP legislature in 2019.Immigration: Wants to extend Deferred Action for Childhood Arrivals …