Operations & Business Management

Latest Headlines

Latest Headlines

Aetna's first-quarter net income falls 7%

Aetna saw its Q1 net income decrease 7 percent--from $777.5 million to $726.6M--from 2015 to 2016, the insurer said in its earnings report Wednesday, and its total medical membership has fallen since the beginning of the year. However, its operating revenue rose 4 percent in the first quarter compared to the same period in 2015  

States take action to ban payers from gender identity discrimination

Insurance companies in Hawaii and Pennsylvania may no longer discriminate against transgendered people when approving coverage for certain medical procedures.

7 emergency procedures account for 80% of deaths, costs

The costs of emergency surgery are soaring, but research published Wednesday in JAMA Surgery found that just seven procedures accounted for 80 percent of admissions, inpatient costs, complications and deaths.

St. Luke's CEO credits evidence-based practices, doc engagement for high-quality ranking

Idaho-based St. Luke's Health System has made Truven Health Analytics' list of the nation's top 15 health systems for the third consecutive year, and CEO David Pate, M.D., credits the ranking to a combination of evidence-based practices, cultural alignment and standardization.

Value-based care may leave teaching hospitals behind

Healthcare needs academic medical centers to drive the innovations and transformation processes currently underway in the industry, but the nature of present-day pay-for-performance measures leaves many such hospitals in the dust, argues a commentary in The Washington Post.

Insurers predict hefty premium hikes in 2017

Citing financial pitfalls over the last two years due to sicker, costlier patients in the Affordable Care Act marketplace, insurers are predicting double-digit premium increases for 2017, according to the Associated Press.

CMS adds flexibility, reduces quality reporting burden in MACRA rule proposal

In a conference call announcing its proposed rule implementing the Medicare Access and CHIP Reauthorization Act of 2015, the Centers for Medicare & Medicaid Services emphasized its desire to work in partnership with physicians in order to craft a flexible payment model that promotes quality care without placing undue burdens on practices or practitioners.

CMS releases MACRA rule proposal

The U.S. Department of Health and Human Services unveiled a proposed rule tackling the initial implementation of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

High procedure volumes don't necessarily equate to better quality

Conventional wisdom holds that hospitals that perform more of the same procedures offer higher quality of care to patients, but that may not be the case, according to a new study in  Applied Health Economics and Health Policy.

Anthem's net income drops 19% in Q1

Anthem's net income dropped 19 percent year-over-year, from $865 million to $703 million, the insurer said in an earnings report out Wednesday. However, the insurer reiterated its 2016 adjusted earnings outlook of greater than $10.80 a share, and it saw an uptick in its total medical membership, which rose 2.8 percent in Q1 2016 compared to the year prior.