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Medicare readmission penalties create quality metrics stress

By Sabriya Rice  |  August 08, 2015

Four years into Medicare's drive to cut the number of patients who land back in the hospital within a few weeks of leaving, only a quarter of more than 3,400 hospitals avoided penalties, contributing to skepticism about the program and the array of metrics used to evaluate healthcare quality.

N.Y. exchange plans to see average 7.1% rate bump

By Bob Herman  |  August 08, 2015

Health insurance premiums on New York's state-run exchange will rise an average of 7.1% next year. But rates differ greatly by payer, plan type and region, highlighting the difficulties of relying on rough averages.

Blog: A good year for healthcare stocks all around

By Michael Sandler  |  July 31, 2015

Some hospital system executives are citing booming insurer stock prices as a clear market signal that consolidation will give payers the upper hand in future price negotiations with hospitals and other providers. But insurers are not the only ones seeing strong results.

Risk that 'nobody will have access to pediatric specialty care'

Risk that 'nobody will have access to pediatric specialty care'

By Modern Healthcare  |  July 18, 2015

Christopher Dawes, president and CEO of Lucile Packard Children's Hospital at Stanford, a 300-bed hospital in Palo Alto, Calif., discusses the issues raised by Medicaid expansion, narrow-network health plans and high prescription drug costs. He spoke with Modern Healthcare reporter Bob Herman.

Former opponents team up to cut drug costs

By Steven Ross Johnson  |  July 17, 2015

Biopharmaceutical companies have begun involving payers, physicians and patient advocacy groups in the early stages of drug development. The goal of partnering bottom line-driven drugmakers with frugal payers is to link the cost of care with patient health outcomes rather than the volume of...

States and insurers need time, money to cement mental-health parity rules

By Virgil Dickson  |  June 12, 2015

States and major insurance companies say they need more time to implement new rules meant to offer better coverage of mental-health and substance-abuse treatment to those in Medicaid managed-care plans. The implications are huge for a population that struggles to get care, especially for...

CMS to release Medicaid managed-care rule

By Virgil Dickson  |  May 23, 2015

The CMS is about to release a sweeping proposed rule that could fuel a major expansion of Medicaid managed long-term care for elderly and disabled beneficiaries.

Cancer docs back bundled pay

By Sabriya Rice  |  May 21, 2015

A payment reform strategy offering consolidated billing codes and bundled cancer-care payments aims to “fundamentally restructure” the way cancer care is paid for in the U.S.

Dr. Stephen Grubbs heads new ASCO department

Dr. Stephen Grubbs heads new ASCO department

By Modern Healthcare  |  May 02, 2015

Dr. Stephen Grubbs has been named senior director of the new clinical affairs department of the American Society of Clinical Oncology in Alexandria, Va.

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