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Editorial: An unfair DSH formula for safety net hospitals

Editorial: An unfair DSH formula for safety net hospitals

By Merrill Goozner  |  July 09, 2016

The CMS continues to adjust its formula for distributing disproportionate-share payments for safety net hospitals based on initial assumptions about insurance coverage under the ACA that have not panned out.

Supreme Court term has mixed results for healthcare industry

Supreme Court term has mixed results for healthcare industry

By Lisa Schencker  |  July 09, 2016

The court's term that ended late last month wasn't nearly so straightforward for the industry. At least half a dozen notable cases left some people cheering and others wringing their hands. And the midterm death of Justice Antonin Scalia appears to have affected some of the outcomes.

CMS proposes expanding diabetes-prevention model

By Virgil Dickson  |  July 09, 2016

In the proposed 2017 physician fee schedule, the CMS suggests expanding a program aimed at helping people avoid diabetes. The CMS suggests starting the program in 2018 and is seeking comment on whether to launch the effort nationally or in additional select markets.

Minn. Blues insurer cuts back ACA exchange participation

By Bob Herman  |  June 25, 2016

Blue Cross and Blue Shield of Minnesota is cutting back its participation in the state's Affordable Care Act insurance exchange next year after losing nearly $300 million in the individual market in 2015.

Under construction: Risk-based reimbursement

Under construction: Risk-based reimbursement

By Dave Barkholz  |  June 18, 2016

The CMS says it's well on its way to dragging hospital systems into the brave new world of risk-based contracting. The systems say, not really.

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