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Weekly News, Analysis, and Commentary

Reimbursement Features & News


Amazon, Warren Buffet and JP Morgan in Healthcare. Why?

(L to R): Warren Buffet, Jeff Bezos and Jaime Dimon / Courtesies of Berkshire Hathaway, Amazon, JP Morgan

Cutting the health insurer out of the middle took a big step forward this week when Amazon, Berkshire Hathaway and JP Morgan announced a partnership to provide health care to their 1 million employees. By the way, it potentially saves them $500 million a year in insurance fees.


Making Bundled Payments Voluntary

Source: Pixabay and RRY Publications, LLC

Dr. Tom Price and CMS want to change bundled payments for joint replacement surgeries from mandatory to voluntary. How will this affect the overall move towards value-based reimbursement systems? The heads of Medtronic and AAOS and a prominent bundled payment consultant offer some (perhaps) surprising insights on the topic. Read what they said.


The Surprising Secret Behind Trumpcare’s CBO Score

Source: Wikimedia Commons, Congressional Budget Office, and Gnome

A new study in The New England Journal of Medicine offered a fascinating look under the hood of the recent CBO scoring of both the House and Senate versions of Trumpcare. It also reinforces the analysis that Trumpcare, if passed in its current form, would reduce demand for orthopedic services by nearly 1%, with spine services being the hardest hit.


DOJ Sues UnitedHealth for Medicare Fraud

Source: Pixabay and Geralt

UnitedHealth faces another whistleblower-backed lawsuit from the Department of Justice. Filed on May 2, 2017, the whistleblowers are offering up details from UnitedHealth employees and former employees who claim they warned the company numerous times about Medicare payment problems.


The LD in DC

Getting the low down on healthcare happenings in Washington, D.C. helps prepare us for challenges—and…

“Obamacare is gone. Just gone”

President Trump / HSS Secretary, Tom Price, M.D. / Source: Wikimedia Commons

Health insurers have just weeks to file their 2018 rate and service plans with the states. Trump and his HHS Secretary, Tom Price, M.D., are threatening to cut off funding for seven million low income ACA insured. If that happens, to quote Trump, “Obamacare is gone. Just gone.” It’s crunch time for insurers and the ACA.