Where healthcare challenges find solutions
As providers and the government try to lower healthcare costs, much of the action rests on lower reimbursement. Meanwhile, patients increasingly are reaching into their own pockets to cover their healthcare costs. They want price transparency and convenient ways to pay their bills, and providers want to maintain healthy margins. Read more about how payment innovations affect the industry.
The Trump administration's idea to tie Medicare drug spending to other countries' lower prices is popular with progressive Democrats, but can HHS Secretary Alex Azar bring Senate Republicans on board? »
The Trump administration is quietly considering allowing states to apply to convert their Medicaid programs into block grants that cap federal spending, which some experts say would lead to lower Medicaid payments for safety-net hospitals.
Health plans clashed with providers and consumers in their reactions to the CMS' proposal to give states more flexibility in regulating the adequacy of provider networks in Medicaid managed-care plans.
Some hospitals have turned to a bold strategy to prevent patients from receiving surprise medical bills from out-of-network providers: requiring in-hospital physicians to contract with the same insurers as the hospital.
The CMS is working to improve a new rule requiring hospitals to post chargemaster prices on their websites after experts said the data wouldn't help consumers, Administrator Seema Verma said Thursday.
The House Oversight Committee set a hearing on high drug prices for the end of January, and lawmakers this week rushed into the drug pricing debate. But the jury's still out on how aggressive Congress will get.
Price transparency stumbled out of the gate last week as hospitals complied with a new CMS requirement to publish their retail charges online for individual services and diagnosis-related groups.
Mental health leaders in eight states are worried about losing federal funding for a Medicaid demonstration that enables them to offer a broad array of services for people with serious mental illness or substance use disorders.
With scheduled DSH payment cuts looming next year, Florida's GOP Sen. Marco Rubio has introduced legislation to overhaul the current formula, which is weighted against his state.
The advisory panel will recommend that Congress slowly phase in disproportionate-share hospital cuts, due to start in October, but will not suggest that lawmakers continue delaying them.
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