News & Analysis as of

Healthcare Costs

Nursing Home Costs Rise Sharply in 2017

The median cost of a private nursing home room in the United States has increased to $97,455 a year, up 5.5 percent from 2016, according to Genworth's 2017 Cost of Care survey, which the insurer conducts annually. Genworth...more

Focus on Health Care Provider Bankruptcies

by Jones Day on

The next few years are expected to see a significant increase in the volume of bankruptcy cases filed by health care providers. Thus far in 2017, the number of bankruptcies in health care-related sectors, including hospitals,...more

Tennessee Department of Health Grants COPA Request for Health Care Alliance

On September 19, 2017, the Tennessee Department of Health (“TDOH”) granted the request for a Certificate of Public Advantage (“COPA”) from Wellmont Health System and Mountain States Health Alliance. This approval paves the...more

Fall Legislative Sessions Commence; Attorney General Certifies Ballot Questions

by Mintz Levin on

Massachusetts lawmakers have returned from summer recess and are preparing to tackle a robust legislative agenda this fall. Legislators will meet formally through the third Wednesday in November, at which point formal...more

Massachusetts Senators Hold Healthcare Roundtable Discussions

by Mintz Levin on

This past August, the Massachusetts Senate and the Millbank Memorial Fund Healthcare Working Group held three roundtable discussions geared towards finding solutions to rising healthcare costs and providing patients with more...more

Washington State AG Alleges Price Fixing and Sues to Break Up Rapidly Expanding Health System

by Mintz Levin on

After five years of growth through a series of acquisitions, the Washington State Attorney General’s office filed a lawsuit to thwart and unwind the most recent expansion efforts of Franciscan Health System (“CHI Franciscan”)...more

Self Insured Groups Save 50% More On Healthcare Coverage with this One - Two Punch: Triage and Customized Quota Share (Rebate)...

by Slim Ventures LLC on

Medium and large employers have found that they can save an average of 30% self insuring the health care of their employees. And while policymakers and pundits lament the need for healthcare reform, self insured groups...more

Why Isn’t My “Free” Preventive Health Care Free?

by Snell & Wilmer on

In my opinion, one of the best changes made by the Affordable Care Act is the mandate that requires health plans to provide certain specified preventive services without imposing any cost sharing. This is sometimes referred...more

Better Healthcare Newsletter from Patrick Malone - June 2017

This mix of medical misconceptions can be harmful to your health - A mix of medical misconceptions may be hurting your pocketbook and harming your health. But there's a ready cure at hand. Take these two evidence-based...more

District Court Rules Online Auction for Medical Supplies Violates Anti-Kickback Statute

by Jones Day on

On March 6, 2017, the U.S. District Court for the District of Connecticut held that an arrangement between a company operating an online portal for purchases of medical equipment and a supplier of medical products violates...more

CMS Delays Implementation of New Payment Models (Again)

On March 21, 2017, the Centers for Medicare and Medicaid Services (“CMS”) published an interim final rule (“Interim Final Rule”) delaying (i) the effective date of several new Medicare payment models developed by the CMS...more

Food for Thought (and Health): Day 2 Notes from the JP Morgan Healthcare Conference

Addressing the Social Determinants of Health: Is the healthcare industry pushing a rock up a hill? We collectively are trying to provide healthcare with improved quality and reduced cost, but the structure of the nation’s...more

“May You Live in Interesting Times” – Some Healthcare Predictions for the Trump Administration’s First Year

The ancient Chinese curse – “May you live in interesting times” – certainly springs to mind these days. What does the election of Donald Trump mean for the healthcare industry, the Affordable Care Act and current healthcare...more

OIG Approves Transportation Assistance Program

by Baker Ober Health Law on

On October 3, 2016, the U.S. Department of Health & Human Services, Office of the Inspector General (OIG), issued an advisory opinion approving a local health care district’s proposal to cooperate with another district to...more

3 ways to save millions & improve access in the costly U.S. health care system

Yes, the good news is that the number of Americans without health insurance has fallen to new lows. But it’s also true that employers, who still provide the bulk of health care coverage in this country, have shifted...more

Better Healthcare Newsletter from Patrick Malone - September 2016

The cancer quandary: improving outcomes as costs explode: It long has been the dreaded C diagnosis: Cancer. For many Americans, the memory persists of a dreadful, deadly disease. But medical science has changed that,...more

PwC Report: 2017 Will Be Year of Equilibrium for Medical Costs

A report issued by PwC's Health Research Institute (HRI) in June projects next year's medical cost trend (i.e., the projected percentage increase in the cost to treat patients) to be 6.5%, which is level to the medical cost...more

One-Two Punch on Hospital Challenges: Is the FTC Down for the Count?

by Proskauer Rose LLP on

There was a time not long ago when the odds of beating the Federal Trade Commission on a hospital merger antitrust challenge were slim. Two recent defeats, however, may change that some. Late last year, the FTC, in quick...more

Hospital Mergers: Is the FTC’s Winning Streak Over?

Following a winning streak dating back to its 2007 win in Evanston, the Federal Trade Commission (FTC) has suffered two losses over the last month in two of its three pending hospital merger challenges. On June 14, 2016, a...more

Manatt on Medicaid: CMS Dramatically Expands Guidance on MMC Plan Payment

Editor's Note: This "Manatt on Medicaid" is the sixth in a series of updates focused on CMS's new Medicaid/CHIP managed care regulations. In the coming weeks, Manatt will continue to explore key provisions of the regulations...more

First of Two Constitutional Conventions on Millionaire Surtax Was a Doozy

by PretiFlaherty on

It was one of the more fascinating events to occur at the State House in a long time, this joint session on Wednesday afternoon, May 18, of the House of Representatives and Senate, or constitutional convention as it’s called...more

Are Drug Prices Really Too High?

by Foley & Lardner LLP on

Those working in the pharmaceutical space are used to hearing complaints about the high costs of drugs, and patents often are blamed for allowing pharmaceutical companies to charge “too much” for their products. But are drug...more

Reforming Medicaid Could Become Toughest Job Ever for Baker Administration

by PretiFlaherty on

Anyone who follows politics or government in Massachusetts has seen these numbers. They bear repeating: - ..Over the past seven years, spending on Medicaid (MassHealth) has increased 65%. ..Next year, total...more

CMS Announces Major Multi-Payer Comprehensive Primary Care Plus (CPC+) Model

by Reed Smith on

CMS has launched a new “Comprehensive Primary Care Plus” (CPC+) model to improve how primary care is delivered and reimbursed. According to CMS, the CPC+ initiative (which builds on the ongoing Comprehensive Primary Care...more

State Efforts to Combat Drug Price Increases

by Foley & Lardner LLP on

Growth in health care costs has long been a source of political and administrative tension for public health agencies across the country. More and more, health officials, legislators, patient advocacy groups, and third-party...more

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