A press release announcing the deal said the privately held company, founded in 1910 by A.J. Mills, will remain under the leadership of the Mills family.
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A press release announcing the deal said the privately held company, founded in 1910 by A.J. Mills, will remain under the leadership of the Mills family.
A controversial new UnitedHealthcare policy intended to tamp down on emergency department visits and costs has drawn ire from providers, while insurance analysts question what, if any, impact the regulation will have.
Texas Children's Hospital will give 2% raises to all employees and award them an extra week of vacation for their efforts during the COVID-19 pandemic.
Public health officials in Illinois are shifting from mass vaccination sites to community outreach, hoping to encourage more hesitant residents to get the shot.
Some providers have sued UnitedHealthcare for failing to pay for COVID-19 tests. The insurer says it will pay CMS reimbursement rates.
CMS Administrator Chiquita Brooks-LaSure wants to know more about how Georgia's plan to privatize its Obamacare exchange could affect equity and access to coverage.
The 260-bed hospital will replace the existing St. Mary Medical Center in Apple Valley, Calif., when it plans to open in 2026.
Empire Blue Cross and Blue Shield, SEIU’s third-party network administrator, told the health plan that its administration agreement would be affected following the resolution of Empire’s own contract dispute with New York-Presbyterian.
Some researchers believe COVID-19 has derailed the fight against HIV, siphoning away health workers and other resources and setting back a U.S. campaign to decimate the AIDS epidemic by 2030.
The health system's deficit accounted for the second wave of COVID-19 cases that hit the city as well as expenses associated with vaccination efforts.
Even amid a pandemic that kept many Americans isolated, gun-related deaths reached a new high of 43,530 in 2020, according to the Gun Violence Archive. Nearly all of these deaths are avoidable. So, should health systems invest in preventing them and addressing their root cause, like they do for medical conditions?
New federal data show a slight increase in healthcare jobs in May. The industry’s employment recovery has been slow since its pandemic-driven nosedive about a year ago.
Recent Medtronic data showed Heartware can unexpectedly stop working and sometimes fail to restart, the Food and Drug Administration said.
The doses mark a substantial — and immediate — boost to the lagging COVAX effort, which to date has shared just 76 million doses with needy countries.
Proposed rules by state workplace regulators would only allow workers to go maskless if everyone in a room is fully vaccinated against the coronavirus.
CMS' Center for Medicare and Innovation could mandate more participation in future models and design its experiments to allow more communities to participate in them.
CMS' Center for Medicare and Innovation could mandate more participation in future models and design its experiments to allow more communities to participate in them.
Around a dozen proposed mergers between relatively healthy not-for-profit systems haven't closed over the past three years as doctors have protested and regulators have become increasingly wary of consolidation.
A handful of nursing homes, assisted living facilities and hospice programs are shutting their doors over staffing shortages.
Intermountain Healthcare named Marti Lolli as president and CEO of the Salt Lake City-based hospital system's SelectHealth health insurance plan.
A California bill would require clinics, skilled-nursing facilities and hospitals to give medical professionals $10,000 each as a form of “hero pay” for their diligence throughout the pandemic.
Three Medicare Advantage plans lost their fight to require CMS to collect data on patient care and satisfaction during the COVID-19 pandemic.
Realyze Intelligence uses natural language processing and other AI to review clinical notes and data in medical records and identify patients at high risk for poor health outcomes, according to UPMC.
Every day, women across our nation rely on the important work and programs provided by all of the federal offices of women's health.
The digital-first, value-based care company Babylon on Thursday said it plans to go public through a special purpose acquisition corporation merger with Alkuri Global Acquisition Corp.
Children who got certain surgeries during the first part of the pandemic were more likely to develop sepsis, according to a new study.
In April, Illinois became the first state to be approved by the U.S. Department of Health and Human Services to extend Medicaid up to a full year after a pregnancy.
“We’ve seen through the pandemic what happens when people don’t have health insurance and how important it is,” said Chiquita Brooks-LaSure. “Our focus is going to be on making sure regulations and policies are going to be focused on improving coverage.”
Detroit, Miami, Phoenix and New York are among the markets with the most room for so-called "payvider" partnerships to grow, a new report finds.
The consultancy Guidehouse studied more than 100 U.S. markets' populations, insurance enrollment and cost and quality metrics to compile its report, which is designed to help providers and insurers in each area decide whether to partner up or go it alone. Increasingly, payers and providers are boosting their returns by teaming up on risk-based collaborations, either in the form of partnerships or formal joint ventures with asset transfers.
The industry is at an inflection point in terms of how payers and providers are incentivized to keep patients healthy, said Dr. Nicole Fetter, a director with Guidehouse.
"Payers need providers to perform on quality, cost and access more than ever to earn full revenue potential," she said, "and providers need payers and purchasers as they're insuring the patients and members that the providers serve."
Guidehouse found the metro areas around Detroit, Miami, Phoenix, Tampa and New York have the highest current Medicare Advantage and managed Medicaid penetration combined with expected enrollment growth. They also showed room for improvement on cost and utilization metrics such as Medicare per capita costs, Medicare Advantage star ratings and emergency department utilization.
Other metros in that category include Charlotte, N.C., Orlando, Cincinnati and Cleveland. Cleveland's rating, for example, suggests there is substantial opportunity to boost value with respect to cost and quality, the report said. There's also demographic shifts happening that will fuel growth in Medicare and Medicaid managed care membership.
Fetter acknowledged that the markets within each of the report's categories are very different from one another, and said it's because a variety of components go into the scores. For example, Miami scored low on value because its Medicare per capita costs are so high. In Detroit, by contrast, there's poor primary care access and higher age-adjusted mortality.
Guidehouse's report, the inaugural Center for Health Insights Payvider Market Index, only included metros with populations above 500,000 based on market size and future growth. It lists metros by population size, and Fetter noted that the larger the population, the bigger the opportunity for membership growth.
The report also grouped together Los Angeles, San Francisco, Riverside, Calif., Minneapolis and Albuquerque, N.M., and said those markets already have a lot of payers and providers coupled with strong cost and quality performance. Guidehouse said that means payers and providers could further differentiate existing value-based payment and delivery options.
In Albuquerque, there are several high-performing players and projected membership growth, the report said.
Another group that includes Seattle, Denver, San Jose, Calif., Salt Lake City and Des Moines, Iowa has relatively low value-based membership growth potential given projected demographic and payer changes, but the existing players score well on cost and quality. In the case of Des Moines, for example, potential Medicare Advantage and managed Medicaid growth is low, so players in that market may want to consider expanding their footprint elsewhere, Guidehouse said.
A fourth group that includes Chicago, Dallas, Houston and Washington, D.C. has low growth potential and didn't perform as well on cost and quality. In the case of Dallas, Medicare Advantage is already high with significant competition. The real opportunity there is for the provider community to differentiate its population health and cost management capabilities, Guidehouse said.
The payvider trend is driven in part by the increased importance of Medicare and Medicaid in the health insurance businesses, especially Medicare Advantage. The biggest and most obvious example of a payvider is UnitedHealth Group's Optum Care subsidiary, which has more than 53,000 doctors and 1,450 clinics nationwide.
Another example is the value-based care joint venture formed in 2016 between Phoenix-based Banner Health and Aetna that they ultimately extended with a longterm agreement in February 2021. Banner and Aetna said they've seen average cost savings of between 8% and 14%, better member experience and growth to approximately 350,000 members.
In the Detroit area, Henry Ford Health System formed a clinically integrated physician network in 2007 that brought together its medical group and independent providers to boost quality and efficiency. It's now one of the country's highest performing Next Generation ACOs and has a direct-to-employer partnership with General Motors.
Modern Healthcare hospital operations reporter Alex Kacik and politics reporter Jessie Hellmann discuss why Democrats want more information about the role private equity and chain ownership of nursing homes plays in patient outcomes.
Eric Lander painted a rosy near future where a renewed American emphasis on science not only better prepares the world for the next pandemic with plug-and-play vaccines, but also changes how medicine fights disease and treats patients.
“Recovery from COVID-19 is not just a health issue. The serious damage to economies and societies needs to be overcome too."
The Oklahoma Supreme Court ruled Gov. Kevin Stitt's plan to privatize much of the state's Medicaid program is unconstitutional.
In a 6-3 ruling Tuesday, the court determined the Oklahoma Health Care Authority did not have the legislative approval to move forward with the plan, dubbed SoonerSelect.
"We find no express grant of legislative authority to create the SoonerSelect program nor do we find the extant statutes implicitly authorize its creation," the ruling states.
The court also determined a constitutional amendment approved by voters last year to expand Medicaid to more low-income people also did not authorize a new managed-care program like SoonerSelect.
The court also found that the Oklahoma Health Care Authority, the state's Medicaid agency, should have made the rules governing competitive bidding widely known prior to implementing a request for proposal and the awarding of contracts.
The Republican governor has pushed the plan to outsource management of the state's Medicaid system to for-profit insurance companies, maintaining that the approach will maximize health care quality while cutting costs.
"The Supreme Court's ruling will unnecessarily delay Oklahoma's efforts to improve health outcomes through managed care, which the Legislature confirmed is the right path forward for our state through Senate Bill 131," Stitt said, referring to a bill approved by the GOP-controlled Legislature that placed some restrictions on the managed care plan. Stitt let that bill become law without his signature.
Stitt said he planned to work with the Health Care Authority to determine how to proceed.
A group of medical organizations filed suit in February seeking to stop the plan, including the Oklahoma State Medical Association, Oklahoma Dental Association, Oklahoma Osteopathic Association, Oklahoma Society of Anesthesiologists and the Oklahoma Chapter of the American Academy of Pediatrics.
"Oklahoma physicians were virtually united in opposition to this plan," Allison LeBoeuf, executive director of the Oklahoma Osteopathic Association said in a statement. "Oklahomans are best served when medical decisions are made between doctor and patient, and without interference from insurance bureaucrats."
Evidence is mounting that immunity from the mRNA vaccines made by Pfizer and Moderna does not depend exclusively on antibodies that dwindle over time.
Starting July 1, Ohio State Wexner patients and providers will be able to request same-day at-home care for viral infections and other illnesses.
The Office of the National Coordinator for Health Information announced $80 million to train and certify traditionally underrepresented workers to the field of public informatics and data science.
A bill from two key healthcare leaders in Congress would permanently fund and expand the Teaching Health Center Graduate Medical Education program.
The state attorney general asked Prospect Medical Holdings to put $80 million in escrow to protect the safety-net hospitals' futures.
Blue Cross and Blue Shield of Oklahoma reached an agreement with the state's largest physician group, just weeks before the transition period out of its contract with OU Health Physicians was set to end.
HHS' Biomedical Advanced Research and Development Authority has launched a new program to spur development of technologies to combat future pandemics and health emergencies.
Sentara Healthcare and Cone Health said they could better serve their respective communities as independent organizations.
Most hospitals made patient health data available digitally in 2019. But their ability to implement electronic portals and API's varied widely, affecting inpatient and outpatient access.
Digital health tool Doximity is the latest company that provide products for physicians to offer an IPO.
Scripps Health's ongoing investigation into a May ransomware attack revealed that the hackers stole copies of documents with patient data.
Health workers renewing their license or registration will have to complete at least one hour of training each year.
In August, workers will physically clock in at least four days a week, and in September, workers will be required to be on campus for nine days of every two week period.
The trade group's revamp comes at a time when the traditional health insurance business has transformed from simply taking on individuals' health risk to directly providing care.
COVID-19 vaccines have allowed nursing homes in the U.S. to make dramatic progress since the dark days of the pandemic, but senior care facilities are still experiencing scattered outbreaks that are largely blamed on unvaccinated staff members.
The top editor of the AMA’s Journal of the American Medical Association is out after his publication hosted a podcast in which a physician suggested not discussing racism.
Ninety-nine percent of Houston Methodist's employees have been vaccinated for COVID-19.
There is a less than 0.001% chance an individual will transmit the virus through blood donation, according to a study by the National Institutes of Health.
Children make up a growing proportion of new COVID-19 cases, and a small number experience long-term symptoms after the virus subsides.
After emerging from bankruptcy in July 2020, Quorum Health is selling its consulting division to a healthcare-focused private equity firm for an undisclosed amount.
Amazon is helping researchers navigate genomics workflows as those processes become more sophisticated.
A man in eastern China has contracted what might be the world's first human case of the H10N3 strain of bird flu, but the risk of large-scale spread is low, the government said Tuesday.
In 11th-hour maneuvers, the city appears to have used its authority to secure certain commitments from the Michigan-based biomedical tech firm taking over the hospital.
COVID long-haulers are facing an illness that less than 100 doctors in the U.S. specialize in.
Even prior to the pandemic, data showed that patients preferred the convenience of virtual care. A survey by patient experience research group SPH Analytics showed 70% of patients preferred virtual visits over an in-person appointment to save time in early March 2020.
Having expanded its Covid-19 testing lab, Mount Sinai is gunning for a contract that would provide testing services to New York City's schools, it announced Tuesday.
Though the drive to create a public health insurance option has made little headway at the federal level, a proposal to create the country's second state-managed public option is moving forward in the Nevada Legislature.
The idea of allowing importation has been around for years, but previous attempts have been blocked by pharmaceutical industry lobbying and safety concerns seconded by government regulators.
Initially, the goal was to vaccinate 250 people a day at each stop. But the numbers have varied, as vaccine supply has increased and demand has fallen.
The central question for Biden: What share of doses should be provided to those who need it most, and how many should be reserved for U.S. partners?
Brian Castrucci of the the de Beaumont Foundation joins the Check Up to talk about lessons learned from COVID-19 and what needs to be done to prepare for the next pandemic.