What is Quality Anyways?: James Hinton, the CEO of Baylor Scott and White, got a good laugh from the audience when he said that he was proud to be one of the five or six hundred hospitals in the nation’s top 100 hospitals....more
1/10/2019
/ Aetna ,
Cancer ,
Clinical Trials ,
CVS ,
Health Care Providers ,
Healthcare Costs ,
Hospitals ,
Investors ,
JPMorgan Chase ,
Partnerships ,
Professional Conferences
Please Don’t Poke the Baby – Sharing a best practice and talking about taking a local hospital learning and turning it into a systemwide approach, Mark Harrison of Intermountain Healthcare shared the fact that taking fewer...more
1/9/2019
/ Affordable Care Act ,
Cancer ,
Drug Pricing ,
Food Safety ,
Health Care Providers ,
Health Insurance ,
Hospitals ,
Medicaid ,
Partnerships ,
Physicians ,
Public Health ,
Public Safety
California recently passed Assembly Bill 315 to create greater regulatory oversight of pharmacy benefit managers (“PBMs”). The bill requires PBMs to provide more transparency regarding their operations. PBMs will have to...more
San Francisco (January 11, 2018) – The final day of the 2018 JP Morgan Healthcare Conference gave us food for thought about the topic of healthcare navigation, as well as updates on the home health sector. Post-acute has...more
1/15/2018
/ Centers for Medicare & Medicaid Services (CMS) ,
Genesis HealthCare ,
Health Care Providers ,
Health Insurance ,
Healthcare Costs ,
Healthcare Workers ,
Home Health Care ,
Hospitals ,
Humana ,
Joint Venture ,
JPMorgan Chase ,
Medicare ,
Mergers ,
Patients ,
Professional Conferences ,
Self-Insured Health Plans ,
Skilled Nursing Facility ,
Telehealth
San Francisco (Wednesday, January 10, 2018) – The third afternoon of the conference was a deep dive into data and analytics, with successive presentations by IBM Watson Health, Inovalon and AthenaHealth and an earlier morning...more
1/11/2018
/ Big Data ,
Data Reporting ,
Electronic Medical Records ,
Genetic Testing ,
Health Care Providers ,
Healthcare Costs ,
Hospitals ,
JPMorgan Chase ,
Outpatient Services ,
Patients ,
Professional Conferences ,
Technology Sector
San Francisco (Tuesday, January 9, 2018): Day 2 of the 2018 JP Morgan Healthcare Conference provided concrete examples of the trends that have been discussed in recent years – the impact of shifting healthcare delivery...more
1/11/2018
/ China ,
Chinese Medicine ,
Chronic Care Managment (CCM) ,
Health Care Providers ,
Healthcare Costs ,
Home Health Care ,
Hospitals ,
Humana ,
JPMorgan Chase ,
Pharmaceutical Industry ,
Professional Conferences ,
Retail Market
San Francisco (Monday, January 8, 2018): Outside it was raining heavily today in San Francisco, but inside the 2018 JP Morgan Healthcare Conference the weather was distinctly sunny. Nary a hint of gloom or pessimism was heard...more
1/11/2018
/ Affordable Care Act ,
Artificial Intelligence ,
Catholic Church ,
Centers for Medicare & Medicaid Services (CMS) ,
Health Care Providers ,
Hospitals ,
JPMorgan Chase ,
Medicaid ,
Medicare ,
Professional Conferences ,
Stem cells
WHO IS AT RISK -
The federal government has indicated that it is still investigating, and could ultimately join a false claims whistleblower qui tam action against Aetna, Inc., Humana, Inc., Cigna, Inc. (through its Bravo...more
In a court decision last year in Swoben v. United Healthcare, the United States Court of Appeals for the Ninth Circuit held that an allegation – that a Medicare Advantage Plan performed a “biased” HCC-RAF retrospective...more
Some interesting presentations on the last day of the JPMorgan Healthcare Conference that concentrated on common themes – the increasing importance of ancillary business line to bolster core business revenue and of filling in...more
Day 3 of the JPMorgan healthcare conference was one of striking contrasts between the old and the new. (And, by the way, the rain finally stopped for a day, but it will be back tomorrow to finish off the last day of the...more
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
A large amount of wind, much discussion about the U.S healthcare, and the public getting soaked again – if you were thinking about Washington, DC and the new Congress, you’re 3,000 miles away from the action. This is the week...more
1/11/2017
/ Affordable Care Act ,
Ambulatory Surgery Centers ,
Employee Benefits ,
Employer Group Health Plans ,
Health Care Providers ,
Medicaid ,
Medicare ,
Medicare Advantage ,
Mental Health ,
Patients ,
Professional Conferences ,
Repeal ,
Telehealth
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
11/10/2016
/ ACOs ,
Affordable Care Act ,
Children's Health Insurance Program (CHIP) ,
Health Insurance ,
Health Insurance Exchanges ,
Healthcare Costs ,
Hospital Mergers ,
Hospitals ,
Industry Consolidation ,
Lobbying ,
Medicaid ,
Medicaid Expansion ,
Medicare ,
Medicare Access and CHIP Reauthorization (MACRA) ,
Physicians ,
Prescription Drug Coverage ,
Presidential Elections ,
Repeal ,
State Taxes ,
Subsidies ,
Telemedicine ,
Trump Administration
A new study by Stanford University researchers finds that Medicare Advantage plans pay lower prices than traditional fee-for-service (FFS) Medicare for most types of hospital admissions. According to the study—published...more
Maryland’s Evergreen Health Cooperative has filed for an injunction against the federal government to halt payment by the Consumer Operated and Oriented Plan (co-op) of the $22 million it owes to CareFirst BlueCross...more
Every year in May, the health ministers from all 194 World Health Organization (WHO) Member States meet at the WHO headquarters in Geneva to attend the World Health Assembly (WHA). As the decision-making body of WHO, the WHA...more
On January 13, 2016, conference sessions surfaced interesting questions and approaches regarding the post-acute sector, bundled payment, emergency medicine and anesthesia.
Post-Acute Focus: With more and more focus on...more
It was another interesting day at JP Morgan, the healthcare conference that never disappoints. Surprising declarations of war and peace, partnering that really works and strong growth stories all were heard today....more
Someone asked me last week what it was like to attend the JP Morgan Healthcare Conference in San Francisco, which started its annual run on January 11, 2016. Outside the conference hotel right now is the obligatory lunchtime...more
A recent Senate Finance Committee hearing investigated the effects of physician-owned distributorships (“PODs”) on costs of care and patient safety, suggesting that the momentum for greater oversight of such business...more
Medicare Part D’s Medication Therapy Management (MTM) program intends to optimize clinical benefits and avoid drug-related problems among eligible beneficiaries. MTM services—involving pharmaceutical and clinical...more
On March 31, 2015, the U.S. Supreme Court issued its decision in Armstrong v. Exceptional Child Center, Inc., holding that Medicaid providers cannot sue to enforce reimbursement standards set forth in federal Medicaid law....more
On Friday, March 20, 2015, the Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule which would make significant changes to the federal Medicare and Medicaid Electronic Health Records (“EHR”) Incentive...more
CMS recently released results of Medicare’s value-based payment modifier for 2015. This is the first year in which physicians are subject to adjustments under the payment system and, in this first phase of implementation,...more