Medicare & Medicaid
For the first time, MA plans may lower cost sharing for drugs such as Naloxone, to treat opioid overdoses.
Use of AI led to cost reductions including a 25 percent drop in hospital length of stay and 91 percent reduction in discharges to nursing facilities.
Massive gaps leave practices more dependent on reimbursement from commercial payers and commercial contracts, raise the potential of shrinking number of Medicare patients accepted.
Volume increase is the main cost driver, as the number of such procedures has sharply risen across nearly all ages under 65.
Two cases emerged from whistleblower claims about improper billing related to discounted drug prices and insulin pens.
Hospitals named in the suit include Vanderbilt Medical Center, Atrium Health, Rush University Medical Center, Ochsner Clinic Foundation and Montefiore Health System.
Also, seven new insurers join America's Health Insurance Plans including Bright Health; CareFirst BlueCross BlueShield.
CMS' renewed interest in mandatory bundled payments includes the possibility of additional participation for oncology and other providers.
Spending for retail prescription drugs reached $333.4 billion in 2017, and those rising costs represent 10 percent of overall healthcare spend.
Arizona is the first state to exempt members of federally-recognized tribes.