Economics

This channel highlights factors that impact hospital and healthcare economics and revenue. This includes news on healthcare policies, reimbursement, marketing, business plans, mergers and acquisitions, supply chain, salaries, staffing, and the implementation of a cost-effective environment for patients and providers.

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Express Scripts considering settlement with FTC to resolve insulin pricing dispute, filing reveals

The Federal Trade Commission said it's seeking a resolution with Cigna, the parent company of the pharmacy benefit manager. The agency filed an antitrust complaint against Express Scripts, Optum Rx and CVS Caremark in 2024, alleging the "Big Three" PBMs use anticompetitive tactics to control the insulin supply chain within their vertical.

Drugs money scam

CMS announces 15 drugs targeted for third round of Medicare price negotiations

The third round of the Medicare Drug Price Negotiation Program includes treatments for HIV and diabetes, among other conditions. The Centers for Medicare & Medicaid Services also released a list of the top 50 medications it deems strong candidates for future negotiations based on current prices and patient utilization.

Trinity Health

Radiology practice prepares to ditch hospital partner 3 years before new contract ends

Danbury, Connecticut-based Advanced Imaging Specialists previously sued Trinity Health in November and is now prepared to vacate their contract amid ongoing challenges. 

American College of Radiology submits 23 imaging-related CPT codes for consideration

ACR presented its proposals at the AMA's Specialty Society Relative Value Scale Update Committee meeting held Jan. 14 to 17 in Los Angeles. 

Medical Debt

Fans and foes of medical debt relief | Heat on the Hill for payer CEOs | One and done with algorithmic care | and more briefings

Several states use taxpayer dollars to help struggling residents pay down medical debt. One is considered a leader of the movement—by critics as well as proponents. 

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‘No Kings’ in healthcare: leaders serve patients by following the clinical problem

California’s decision to restrict the use of the title “doctor” in clinical settings underscores a growing disconnect between healthcare policy and the realities of modern care delivery. In an op-ed, health policy professor and former Virginia legislator, Dawn M. Adams, DNP, and Marissa J. Levine, MD, a public health physician and former Virginia health commissioner, argue that rigid physician-centric hierarchies no longer reflect how patients actually receive care.

Heartflow Plaque Analysis

How to stay ahead of the changing CCTA reimbursement landscape

It is critical for organizations to have a firm understanding of the CMS 2026 Final Rule to bolster reimbursement, plan service lines and ensure continued access to CCTA, FFR-CT and AI-enabled plaque analysis. 

CVRx hopes new research will expand access to heart failure therapy

The BENEFIT-HF trial, scheduled to begin enrollment in the months ahead, could significantly increase the number of patients eligible for CVRx's Barostim therapy.