Top Stories

Hospitals broaden scope of community-benefit work

By Beth Kutscher  |  November 21, 2015

As the need for charity care drops, some hospitals and health systems across the country are targeting funds to address societal ills such as poverty, violence, hunger, poor nutrition and lack of housing.

Late News

The ACA may have caused big increase in improper Medicaid payments

By Modern Healthcare  |  November 21, 2015

The CMS said the Affordable Care Act may have caused a significant increase in improper Medicaid payments. The rate of improper payments has jumped from 5.8% or $14.4 billion in fiscal 2013 to 9.78% or $29.12 billion in fiscal 2015, according to an HHS financial audit.

The Week Ahead
Regional News

Daughters struggles as AG weighs takeover decision

By Beth Kutscher  |  November 21, 2015

Daughters of Charity Health System faces a precarious financial position while waiting for California Attorney General Kamala Harris to decide whether to allow its sale to private-equity firm Blue Mountain Capital.

Care New England, Southcoast consider merger

By Adam Rubenfire  |  November 21, 2015

Care New England Health System of Providence, R.I., and Southcoast Health System of New Bedford, Mass., announced last week that they are exploring a merger.

Houston hospital terminated from Medicare

By Maria Castellucci  |  November 21, 2015

In a rare move, the CMS will terminate Medicare and Medicaid funding at St. Joseph Medical Center in Houston next month after an investigation found the hospital was noncompliant with federal rules.


Midwest systems see opportunity where Advantage enrollment lags

By Bob Herman  |  November 21, 2015

Two large Midwest health systems are building an insurance plan together around Medicare Advantage, and the joint venture marks yet another example of providers' burning ambition to get into the insurance game. And many of them are honing their play in the Medicare league.

Bundled payment demo has nursing homes seeing stars

By Melanie Evans  |  November 21, 2015

Hospitals in more than five dozen metropolitan areas will soon have no choice but to take bundled payments from Medicare for hip and knee replacements. And the skilled-nursing facilities that do business with them face a stark reality of their own.

CMS' 'doc fix' may need some repairs itself

By Shannon Muchmore  |  November 21, 2015

Hospital and physician groups, facing a looming deadline on major changes to reimbursement, say the CMS needs better measures and reporting methods before it ties physician pay to quality and outcomes.

U.S. hospitals take different approach than French in mass-casualty planning

By Adam Rubenfire  |  November 21, 2015

Soon after terrorist attacks that led to 130 deaths and wounded more than 350 others Nov. 13 in Paris, the city activated its Plan Blanc strategy, a coordinated response to mass casualty. It was a calculated effort that was largely facilitated by the mostly municipal governance of its hospitals.

Why the healthcare industry shouldn't panic about UnitedHealth's ACA alarm

By Bob Herman  |  November 20, 2015

Even if UnitedHealth Group does bail, it's by no means certain that other insurers—many of which are more heavily invested in the exchanges—would immediately follow. And some analysts say UnitedHealth's announcement was mostly about putting pressure on the Obama administration.

Cover Story

Hospitals broaden scope of community-benefit work

By Beth Kutscher  |  November 21, 2015

As the need for charity care drops, some hospitals and health systems across the country are targeting funds to address societal ills such as poverty, violence, hunger, poor nutrition and lack of housing.


Editorial: A cloudy dawn for biosimilars

By Merrill Goozner  |  November 21, 2015

Generic versions of off-patent drugs, which today account for more than 88% of all prescriptions, save patients and the U.S. healthcare system hundreds of billions of dollars per year. That isn't turning out to be the case with biosimilars.

Guest Commentary

Strengthen palliative care to help build a more patient-centered system

By Mark Ganz  |  November 21, 2015

It was as a son, not a healthcare CEO, that I experienced the pain of my mom's “do not resuscitate” order being ignored. Her medical team pushed through the door and subjected her to a full code, against her wishes, the night her heart beat for the last time.

Best Practices

Best Practices: How urban hospitals can boost local hiring

By Lisa Schencker  |  November 21, 2015

When University of Chicago Medicine held a job fair at a local church a couple of years ago, hospital officials expected a few hundred attendees. To their surprise, about 1,100 South Side residents showed up.


Q&A: Politicians' ACA stance depends on how close they are to the point of service

By Modern Healthcare  |  November 21, 2015

CEO George Masi and other leaders of Houston's Harris Health System drew the ire of Texas Gov. Greg Abbott for pushing for Medicaid expansion while the state was trying to renew its big Medicaid waiver. Masi discusses the politics of Medicaid and tightening the charity-care policy at Harris.

By the Numbers

SNF leaders wary of new ACO rule

By Michael Sandler  |  November 21, 2015

Skilled-nursing facilities are seeking more say in how they contract with accountable care organizations as a new CMS rule for ACOs loosens the coverage policy for some Medicare patients, experts say.

Largest skilled-nursing providers, 2015

November 21, 2015

A list of the nation's 20 largest skilled-nursing providers, ranked by revenue in 2014. Source: Modern Healthcare's 16th annual Post-Acute Care Survey, Securities and Exchange Commission filings and Internal Revenue Service filings. Published Nov. 23, 2015, p. 34.

News Makers

Connolly new CEO of not-for-profit insurance alliance

By Modern Healthcare  |  November 21, 2015

Ceci Connolly, 52, is president and CEO of the Alliance of Community Health Plans, a Washington-based trade group that represents large not-for-profit health insurers, including Kaiser Permanente and UPMC Health Plan.

Data Points

Data Points for Nov. 23, 2015

By Modern Healthcare  |  November 21, 2015

Data Points for the week of Nov. 23, 2015, covered the following topics: Privatizing veterans hospitals, HIV, number of uninsured Americans


Murthy praises doc who made a difference

By Modern Healthcare  |  November 21, 2015

After spending about 12 minutes urging attendees at a recent American Public Health Association meeting to go forth and do great things, U.S. Surgeon General Dr. Vivek Murthy used the story of high school student Jill Stewart as an example of how one person can make a difference.

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