Today’s Headlines ▶

While payer-provider collaboration has long been important, new trends in managing population health data is strengthening that relationship as never before, according to MedeAnalytics CEO Andy Hurd, and in many ways it's changing how providers think. MORE
Out-of-network providers charged patients on average 300 percent more than the Medicare rate for certain treatments or procedures, according to the analysis of 2013 and 2014 claims data released Thursday by the America's Health Insurance Plans. MORE
New Hampshire hospitals Dartmouth-Hitchcock, Elliot Health System and Frisbie Memorial Hospital are joining with Harvard Pilgrim Health Care to create a new analytics company to manage the clinical and financial data across the organization. MORE
Chronically ill people enrolled in individual health plans sold on the Affordable Care Act insurance exchanges pay on average twice as much out-of-pocket for prescription drugs each year than people covered through their workplace, according to a study published Monday in the Health Affairs journal. MORE
While the Supreme Court decision in King v. Burwell that cleared subsidized health insurance premiums under the Affordable Care Act removed a lot of uncertainty from hospital finance, little has changed when it comes to hospitals' access to debt. But that may change. MORE
On Thursday, providers dealt with system issues, which will be followed by productivity issues and then payment issues, according to healthcare insiders. MORE
Healthcare Finance spent the bulk of Thursday's rollout monitoring the buzz, speaking with experts and reporting on any issues that may have arrived. While the true effects of the change will be felt in the coming weeks when claims are processed, bills delivered and accounts receivable wane, we have a few observations to share. MORE
The federal government needs to increase its oversight over private Medicare health plans to make sure seniors have adequate access to doctors and hospitals, according to a report released this week by congressional auditors. MORE
Insurance companies will pay $362 million to the federal government's shared risk program beginning this November for 2014 participation, but will be short $2.5 billion in payments that they hoped to receive from the federal government, the Department of Health and Human Services announced on Thursday. MORE
Healthcare IT News and sister site Healthcare Finance will be reporting on the changeover throughout the day, using the live blog below to highlight the latest news, real-time reactions and frequent updates from our cadre of volunteer ICD-10 correspondents. MORE
A federal judge has partly sided with providers in ordering the Centers for Medicare & Medicaid to provide further justification for the 0.2 percent payment reduction in provider compensation that will kick in under the two-midnight rule, according to the September 21 ruling in U.S. District Court in Washington D.C. MORE
The health law's upcoming enrollment period may be its toughest yet, with federal officials promising a vigorous outreach campaign to enroll millions of eligible yet hard-to-reach Americans who have yet to sign up for health insurance. MORE
The five-year model will be tested in seven states starting in January 2017: Arizona, Indiana, Iowa, Mass., Pennsylvania Tennessee and Oregon. MORE
Mark T. Bertolini, chairman and CEO of Aetna in Hartford, Connecticut and Joseph R. Swedish, president and CEO of Anthem in Indianapolis, argued before a Senate Judiciary subcommittee on Antitrust, Competition Policy and Consumer Rights on Tuesday that local insurance plans would keep the industry competitive. MORE
The National Committee for Quality Assurance has released its newest rankings for health plans in the United States based on clinical and satisfaction scores.  MORE
Earlier this week, Turing Pharmaceutical CEO Martin Shkreli drew sharp criticism after his privately held company boosted the price of AIDS treatment drug Daraprim from a reported $13.50 a tablet to $750. MORE
A new consumer website unveiled by the California Department of Insurance hopes to help Californians better shop for healthcare based on both quality and price. MORE
According to new data released by the Centers for Medicare and Medicaid Services on Monday, the U.S. government has paid nearly $2.3 billion through July in incentives to close the coverage gap in 2015. MORE
Medicare Advantage premiums will fall by 31 cents in 2016, the Centers for Medicare & Medicaid Services said on Monday amid surging enrollment to the privately managed program. MORE
The National Committee for Quality Assurance recently ranked more than 1,500 health plans by satisfaction and service. The ranking includes private as well as government-sponsored Medicare and Medicaid plans. MORE
More Americans are getting health insurance either through private or government plans than they were in 2013, according to U.S. Census figures for 2014 released Wednesday that points to the Affordable Care Act as a major driver for the change. MORE
Consumers will earn Walgreens Balance Rewards points for enrolling in and funding accounts, activating benefit debit cards, making purchases using their cards, or by participating in healthy activities such as walking, biking and weight management. MORE
Employers again are sharply focused on employee wellness, and some are raising the bar to qualify for program incentives. MORE
Enrollment figures released this week by the Centers for Medicare & Medicaid Services show close to 10 million people have signed up for insurance through the Health Insurance Marketplace, as of June 30. CMS said 9.9 million individuals had paid their premiums and had an active policy by the end of June. MORE
As a Standard & Poor's report finds many insurers are missing the mark on their risk-adjustment predictions, a new partnership between population health management consultant Evolent Health and Health Fidelity, which develops technology to steer providers towards value-based care, aims to fill the gap. MORE
Legislators on Thursday were split on the Affordable Care Act's effect on provider and payer competition in the healthcare marketplace in the the first of several hearings to be held by the House Judiciary Subcommittee on Regulatory Reform, Commercial and Antitrust Law. MORE
Hackers had unfettered access to Excellus BlueCross BlueShield's information systems for more than a year and a half before the health plan even noticed the cyberattack had occurred. MORE
The Center for Medicare and Medicaid Services has rolled out a new Medicare Advantage Value-Based Insurance Design Model that will be tested in seven states starting in 2017 as a way to trim costs in the treatment of certain chronic conditions. MORE
California legislators passed a bill postponing a controversial plan that would have shifted tens of thousands of medically fragile children into Medi-Cal managed care plans. MORE
Managed care company Molina Healthcare said it will pay $200 million for the remaining stakes in two subsidiaries of The Providence Service Corp. MORE
Although many organizations participating in the Medicare Shared Savings and the Pioneer Accountable Care Organization programs failed to generate savings in 2014, Navigant Healthcare consultant Paul Keckley thinks the programs are here to stay despite several flaws. MORE
The long-awaited rules from the Office of Civil Rights in the Department of Health and Human Services further define protections included in the Affordable Care Act, particularly broadening those for transgender Americans. MORE
Even when a natural disaster doesn't force a hospital to shut its doors, unexpected catastrophes can disrupt operations and finances. MORE
The Marketplace Navigator grants only apply to groups in the 34 states that run federal exchanges. MORE
While hospital merger and acquisition deals in the second quarter of 2015 slid when it came to volume, the total dollar amount of the deals jumped on a few major takeovers, according to new research by PricewaterhouseCoopers. MORE
Colorado's uninsured rate has plummeted from a recent high of 15.8 percent four years ago to 6.7 percent this year, but the success of the Affordable Care Act in Colorado is almost entirely the result of Medicaid expansion, according to a much anticipated survey from the Colorado Health Institute. MORE
While many accountable care organizations in Medicare's Shared Savings Program generated enough savings in 2014 to merit financial incentives, more than two-thirds fell below the payment threshold, the Centers for Medicare & Medicaid Services said on Tuesday. MORE
Nine ACOs that partner with CHS generated $27 million in the Medicare Shared Savings Program. MORE
Two Pioneer Accountable Care Organizations, Montefiore Health and the Banner Health Network, on Tuesday touted their success in generating savings for the Centers for Medicare & Medicaid Services ACO model. Though other organizations in the group found little reason to celebrate. MORE
Amputees against proposed changes to Medicare coverage that would result in less expensive, but inferior, prosthetics being given to patients gathered in Baltimore Wednesday to ask officials to strike down the proposal. MORE
A new report published in the American Journal of Managed Care found that just over half of MSSP ACOs shared plans on how they'll allocate savings. MORE
More than 2 million people with coverage on the health insurance exchanges may be missing out on subsidies that could lower their deductibles, copayments and maximum out-of-pocket spending limits, according to a new analysis by Avalere Health. MORE
MeriTalk report claims 11 percent of people who receive government healthcare benefits are not actually eligible. MORE
Narrow insurance networks are gaining traction across the United States, as insurers have limited options for offering plans at different price points, according to a report by the Leonard Davis Institute of Health Economics and the Robert Wood Johnson Foundation. MORE
Experts say problems seen in September in testing ICD-10 codes could turn into disasters when the new diagnostic code set goes live on October 1. MORE
Though critical access hospitals will continue to earn less, Fitch Ratings this week said it does not expect the financial struggles to affect these hospitals' credit ratings due to their near 100 percent reimbursement from Medicare and political support that will stave off any attempt to cut payments. MORE
Pennsylvania families that faced penalties for Children's Health Insurance Program coverage that did not meet minimum requirements set by the Affordable Care Act are in the clear after Gov. Tom Wolf on Thursday said the state expanded its CHIP program. MORE
Republican presidential candidate Scott Walker has released details of a healthcare model to replace Obamacare that would give tax credits to seniors to buy their own insurance. MORE
Blue Cross and Blue Shield of Illinois has developed accountable care organizations with three more provider-partners, bringing the total number of ACOs under the insurer to five, the insurer announced this month. MORE
A doctor at a Brooklyn, New York, clinic was sentenced Friday to two years in prison for his role in a $13 million healthcare fraud scheme, according to the U.S. Department of Justice. MORE

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