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Mar 22, 2018

Ascension is restructuring as it pursues new strategic direction, hinting at transitioning from a hospital-oriented system to one that's focused on outpatient care and telemedicine, the largest Catholic health system told its 165,000 employees early Friday morning via a video featuring Ascension President and CEO Anthony Tersigni that Modern Healthcare has exclusively obtained.

Earlier this month, the Ascension board of directors unanimously endorsed its new "advanced strategic...

Mar 22, 2018

The departure of seven accountable care organizations from CMS' Next Generation ACO Model program will likely not threaten the viability of the program, but the reasons behind the early exit are costing providers millions.

The Accountable Care Coalition of Chesapeake, Allina Health, Fairview Health Services, KentuckyOne Health, Lifeprint ACO, MemorialCare and Sharp HealthCare have left the program for 2018 although they will likely still be on the hook for any losses from the 2017...

Mar 22, 2018

In a blow to health insurers, the House on Thursday passed a $1.3 trillion, two-year omnibus spending bill that didn't include funding for cost-sharing reduction payments or a federal reinsurance program. Insurers had been lobbying hard to get something included in the massive spending bill. Absent that lifeline, insurers will likely be raising premiums and rethinking their participation in the individual market in 2019.

The omnibus bill, which the Senate must pass by midnight on...

Mar 22, 2018
Lowering documentation standards for a commonly used set of billing codes would lead to better quality of care, doctors told the CMS during a conference call Wednesday.

Most physicians bill Medicare for patient visits under a relatively generic set of codes that distinguish the level of complexity and site of care. They are called evaluation and management visit codes. The last significant update to the E/M guidelines was more than 20 years ago.

"The agency has heard repeatedly over...

Mar 22, 2018

The CMS is letting some states off the hook when it comes to complying with an Obama-era rule that's meant to ensure Medicaid beneficiaries have adequate access to care.

In 2015, the CMS finalized a rule requiring states to assess how easy it is for fee-for-service Medicaid beneficiaries to receive primary care; pre- and post-natal obstetric services; and specialty and behavioral health care, among other services.

On Thursday, the CMS issued a proposed rule that would exempt...

Mar 22, 2018

John Bardis announced he is departing as HHS assistant secretary for administration effective immediately.

The founder and former CEO of MedAssets was appointed last year by former HHS Secretary Tom Price. Bardis said he always planned on serving only one year.

"It has been the privilege of a lifetime," Bardis said in a statement.

The post was one of the highest in command at the agency and was charged with oversight of maintaining security of the medical information of...

Mar 22, 2018

Regulators cleared the merger between Advocate Health Care and Aurora Health Care, paving the way for a 27-hospital system spanning Illinois to Wisconsin with $10.7 billion in combined revenue, the organizations announced Thursday.

The Federal Trade Commission and the chair of the Illinois Health Facilities & Services Review Board signed off on the proposed deal in February. The merger, which would unite comparably sized systems to form the country's 10th largest not-for-profit...

Mar 22, 2018

After failing last week to pass the so-called "right to try" bill, members of the House finally approved the measure Wednesday night.

The bill would allow terminally ill patients access to unapproved drugs without federal regulatory oversight.

The bill passed 267-149 after House Democrats tried and failed to delay the final...

Mar 22, 2018

Medical bills can push patients over the financial cliff, but a new study says this may not happen as often as previous research suggests.

Hospitalizations cause only about 4 percent of personal bankruptcies among non-elderly U.S. adults, according to an analysis published Wednesday in the New England Journal of Medicine.

This contrasts with previous research by former Harvard professor and current U.S. Sen. Elizabeth Warren and others that pointed to medical reasons as the...

Mar 21, 2018

Of the $88 billion HHS appropriation announced Wednesday night, not a penny is going toward Obamacare. Instead, Congress is slapping oversight requirements on HHS regarding its administration of the health exchanges.

Congressional leaders released the long-awaited $1.3 trillion, two-year spending omnibus after days of wrangling behind closed doors over contentious policies that included an embattled stabilization package for the individual market that would fund cost-sharing...