Healthcare Finance Staff

LAS VEGAS -- When Inova Health saw that Affordable Care Act initiatives for value-based care would cut 7 percent, or $220 million, out of the $3 billion health system's successful fee-for-service revenues, the northern Virginia provider knew it needed to change, said President and COO Mark Stauder.

MIT Sloan Professor Andrew Lo, Dana-Farber Cancer Institute's David Weinstock, and MIT post-doctoral fellow Vahid Montazerhodjat have identified this as a time when breakthrough therapies for certain types of cancers, hepatitis C, and rare diseases exist but remain out of reach for many patients, due primarily to the prohibitive cost.

The Centers for Medicare and Medicaid Services on Monday issued its final annual notice of benefit and payment parameters for the 2017 health insurance marketplace.

The head of Aetna Inc., the nation's third-largest health insurer, said he supports insurance exchanges, even though he questioned their sustainability earlier this month and lost money in the marketplaces last year.

Health information exchange is an essential tool to support the transition to value-based payment models, according to Alex Baker of the U.S. Department of Health and Human Services, who gave an overview of federal initiatives and how states, hospitals and physicians can benefit from the innovations, during HIMSS16 in Las Vegas.

South Dakota Gov. Dennis Daugaard has announced the state will not seek Medicaid expansion this legislative session, saying with only a few days left during the current stretch there isn't enough time to thoroughly consider the issue.

The Centers for Medicare and Medicaid Services is now requiring consumers who sign up for health insurance coverage during special enrollment periods to submit proof of eligibility, a move that the health insurance industry is applauding.

The Centers for Medicare and Medicaid Services has proposed, in its new Medicare Advantage rate notice, to waive the bidding requirement for employers and union groups that offer retirement plans to their employees.

Republican Iowa Governor Terry Branstad has announced expanded Medicaid coverage for eligible residents in his state through a program he is calling Medicaid modernization.

The Centers for Medicare and Medicaid Services on Friday released proposed changes for the Medicare Advantage and Part D prescription drug programs for 2017, including an increase in the net payment rate for Medicare Advantage of 1.35 percent, CMS said.