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.

UnitedHealthcare

UnitedHealthcare sues Radiology Partners again, claiming mega practice ‘weaponized’ surprise billing protections

Rad Partners "firmly" denied the allegations, which mirror a similar complaint from Aetna, contending it plans to "vigorously defend against these claims" in court. 

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Recent fraud cases suggest ‘fake nursing’ has become a troubling career path

A new report reveals that states are keeping databases on “imposter nurses” to slow what could be a growing trend of unlicensed individuals holding nursing positions at hospitals nationwide. 

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Johnson & Johnson MedTech hit with permanent injunction as fallout over antitrust lawsuit continues

Johnson & Johnson MedTech was already ordered to pay $442.2 million in damages for withholding clinical support to healthcare providers. Now the company has been hit with a permanent injunction designed to stop it from being a repeat offender.

Medicare money bills dollars

Under-reimbursement keeping radiologists from using key imaging modality, docs warn CMS

Radiologists and other physicians recently wrote to Administrator Mehmet Oz, MD, asking for changes related to contrast-enhanced ultrasound. 

Anders Gilberg, MGA, senior vice president, government affairs at Medical Group Management Association (MGMA) explained the need to renew the Medicare geographic pay adjustments in rural areas to make payments more competitive than urban areas. He said this is vital to help retain physicians in rural areas who otherwise could find higher paying jobs in larger cities.

Looming end of Medicare rural pay adjustment raises concerns about doctor shortages

Anders Gilberg, senior vice president of government affairs at the Medical Group Management Association, explains why Congress needs to renew the Medicare geographic pay adjustments in rural areas—to make payments competitive with urban areas and help retain physicians in those communities.

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New $6B Eversana looks to bypass PBMs and lower drug prices

A merger between Eversana and Waltz Health will create a new entity that CEO Mark Thierer says will upend the “existing oligopoly that I helped build.”

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New York cardiologist headed to prison—DOJ says he paid for referrals, performed unneeded procedures

"Today’s sentence sends a deterrent message to doctors and the healthcare industry," according to a DOJ statement. "If you abuse patient trust for profit, you will face justice."

Summa Health

Hospital system no longer accepting radiology patients with out-of-network health plans

Summa Health said the change will take effect Sept. 1, with the two-hospital network ceasing scheduling of appointments for this consumer segment.