Health Care Quality Digest

NYSE tells Amwell to increase share prices or be delisted

Fierce Healthcare

APRIL 5, 2024

Amwell could find itself dropped from the New York Stock Exchange if it isn’t able to turn its share prices around. | The telehealth giant's shares have closed below $1 on average for the past 30 days. The company said it would address the deficiency by effecting a reverse stock split.

House price transparency legislation passes with bipartisan support

Fierce Healthcare

DECEMBER 11, 2023

The Lower Costs, More Transparency Act, which advances policies to force pharmacy benefit managers and hospitals to meet price transparency standards, passed on the House floor Monday by a vote of | Members on both sides of the aisle are celebrating successful efforts to codify price transparency requirements and establish site-neutral payments in (..)

Hospitals

Foo Fighters to expose 'the pretenders' in price transparency concert

Fierce Healthcare

FEBRUARY 22, 2024

Fans of healthcare price transparency and Grammy Award-winning bands should have their calendars marked for March 5 in Washington, D.C. | The Foo Fighters are joining the fight against price transparency with an upcoming, private concert in Washington, D.C., on behalf of advocacy group Power to the Patients.

Healthcare

Hospital price transparency compliance dips: report

Health Care Dive

MARCH 4, 2024

Lenient regulatory enforcement has led hospitals to disregard price transparency requirements, according to watchdog group Patient Rights Advocate.

Hospitals

Price transparency startup Turquoise Health picks up $30M series B funding

Fierce Healthcare

JANUARY 23, 2024

Price transparency data startup Turquoise Health clinched $30 million in fresh funding to build out its capabilities. Price transparency data startup Turquoise Health clinched $30 million in fresh funding to build out its capabilities.

Hospital, payer price transparency compliance improves, but new requirements are kicking in this year

Fierce Healthcare

JANUARY 3, 2024

A “pivotal year for price transparency” closed out with most—but not all—of the healthcare industry publishing their data publicly and at a higher quality, price transparency data startup Turquoise | A state-of-the-industry report released Thursday found steady improvements in the number of organizations releasing price data, as well as the comprehensiveness (..)

Hospitals

Hospitals Healthcare

More hospitals, payers compliant with price transparency laws

Health Care Dive

JANUARY 5, 2024

More than 90% of hospitals posted files at least partially compliant with price transparency requirements in 2023, according to a new report from Turquoise Health.

Hospitals

CVS Health revamps pharmacy reimbursement model amid scrutiny on high drug prices

Fierce Healthcare

DECEMBER 5, 2023

CVS Health is overhauling the way it reimburses its pharmacies for prescription medications as the healthcare industry faces increased scrutiny for high drug prices. | CVS Health is overhauling the way it reimburses its pharmacies for prescription medications as the healthcare industry faces increased scrutiny on high drug prices.

Healthcare

US sues Regeneron, alleging false price reporting on Eylea

Health Care Dive

APRIL 11, 2024

The Department of Justice accused Regeneron of defrauding Medicare by knowingly inflating the average sales price for its top-selling eye drug.

Medicare

House committees introduce new healthcare price transparency legislation

Fierce Healthcare

SEPTEMBER 8, 2023

A trio of House committees unveiled new legislation (PDF) Friday to lower costs and increase transpar | Several house committees dropped new legislation Friday meant to improve price transparency for patients and employers. Here's what they're proposing.

Healthcare

2024 Outlook: Drug price negotiations, Braidwood highlights top legal cases to watch

Fierce Healthcare

DECEMBER 18, 2023

Legal experts indicated they will be paying close attention to lawsuits surrounding the Medicare drug price negotiation program and Braidwood v. Preventative services covered under the Affordable Care Act and the Medicare drug price negotiations program are two legal questions that will play out next year.

Medicare

Medicare Prevention

New Walgreens CEO signals pharmacy giant will shift to new drug pricing models

Fierce Healthcare

JANUARY 5, 2024

In his first earnings call since taking over as CEO of Walgreens, Tim Wentworth signaled the drugstore retail giant is exploring new pharmacy models as cost-plus drug pricing gains momentum. |

Hospital M&A studies highlight higher prices, tepid antitrust intervention

Fierce Healthcare

APRIL 25, 2024

Both painted an unflattering picture of post-merger prices and were refuted by the hospital lobby.

Hospitals

Hospitals Regulations Healthcare

Astellas withdraws lawsuit challenging Medicare drug price program

Health Care Dive

SEPTEMBER 7, 2023

Contrary to the drugmaker’s expectations, its top-selling cancer medicine Xtandi wasn’t picked as one of the first 10 drugs to face price negotiations.

Medicare

Hospitals share differing medical prices online versus over the phone, secret shopper survey finds

Health Care Dive

SEPTEMBER 18, 2023

The study raises new questions about the dependability of hospital pricing, and builds on a mountain of research finding wide variance in pricing between different hospitals — and within the same facility.

Hospitals

Certainly, a free booking platform with upfront prices, clinches $2.3M

Fierce Healthcare

DECEMBER 15, 2023

Certainly Health, a new patient-facing platform focused on upfront prices, has received $2.3 million in funding. Certainly claims to be the first marketplace for patients to book doctors with their insurance while avoiding any surprise bills. It's free for patients.

Doctors

Biden administration flags dozens of pharma companies to pay Medicare rebates for 'outrageous' price hikes

Fierce Healthcare

DECEMBER 14, 2023

The Biden administration is cracking down on pharmaceutical companies as part of its price-fighting measures under the Inflation Reduction Act. | The Biden Administration announced Thursday a list of 48 Part B drugs with prices that rose faster than the rate of inflation in the final quarter of 2023.

Pharmaceuticals

Pharmaceuticals Medicare

Hospitals' online and over-the-phone cash prices rarely align, study finds

Fierce Healthcare

SEPTEMBER 19, 2023

Patients checking their local hospital’s website for the cost of medical services may not find the same prices as those who called on the phone, according to a newly published study. |

Hospitals

Hospitals Medical Services Healthcare

FTC sues PE-backed anesthesia provider for monopolistic roll-ups, price setting

Fierce Healthcare

SEPTEMBER 21, 2023

Federal regulators have accused a major Texas-based anesthesia provider and its parent private equity firm of a decade-long, three-pronged scheme to suppress competition and drive-up prices. |

Regulations

The legal battle over drug price negotiations is just getting started

Fierce Healthcare

SEPTEMBER 13, 2023

Pharmaceutical companies are waging war against federal agencies over one of the Inflation Reduction Act’s major provisions allowing Medicare to negotiate 10 drugs to reduce out-of-pocket costs for | Legal experts question whether the Inflation Reduction Act is within its rights to enforce its drug pricing negotiation provision.

Pharmaceuticals

Pharmaceuticals Medicare

Price transparency proposal leaves room for improvement, experts say

Fierce Healthcare

AUGUST 1, 2023

Experts believe recent price transparency initiatives from the Centers for Medicare & Medicaid Services (CMS) are a step in the right direction but ultimately fall short of making the impact al | Price transparency initiatives could help consumers make better decisions with their wallets, but experts have tempered expectations of the real-world (..)

Medicaid

Medicaid Medicare

Physician-owned hospitals' negotiated, cash prices lower than nearby facilities, study finds

Fierce Healthcare

JUNE 22, 2023

Physician-owned general acute care hospitals charge less than other non-physician-owned facilities in their region for several common shoppable care services, according to a new analysis published | A new analysis of competing hospitals' published prices adds fuel to the debate over whether Congress should lift the Affordable Care Act's ban (..)

Hospitals

Boehringer sues to block US drug price program

Health Care Dive

AUGUST 22, 2023

The pharma’s suit, which claims Medicare’s new power to negotiate certain drug prices is unconstitutional, comes days before the agency will reveal the first 10 medicines to be included under the plan.

Medicare

AARP court brief backs Medicare price negotiation program

Fierce Healthcare

AUGUST 21, 2023

In a federal lawsuit, AARP is supporting Medicare’s new ability to negotiate drug prices with pharmaceutical companies, ahead of CMS naming the first 10 prescription drugs next month. The nation’s leading lobbying group for older Americans is supporting the U.S. |

Medicare

Medicare Pharmaceuticals

Lawsuit accuses Advocate Aurora of charging ‘eye-watering’ prices

Health Care Dive

FEBRUARY 12, 2024

The lawsuit accuses the health system of using acquisitions, noncompetes and gag clauses to create a monopoly and increase prices.

Healthcare cost growth trails overall price hikes amid record inflation

Health Care Dive

AUGUST 25, 2022

Prices in the U.S. in July compared to last year, while prices for medical care increased just 4.8%, according to a tracker from the Kaiser Family Foundation and Peterson Center on Healthcare. economy grew 8.5%

Healthcare

Major hospitals still noncompliant with price transparency rules

Health Care Dive

FEBRUARY 6, 2023

No hospitals in HCA Healthcare, Tenet, Providence and UPMC systems were fully compliant with federal price transparency rules, according to a new analysis.

Hospitals

Hospitals Healthcare

Here are 25 Medicare Part D drugs that have skyrocketed in price

Fierce Healthcare

AUGUST 10, 2023

Medicare Part D drug prices have increased by an average of 226% since market entry. A report from AARP broke down how popular brand-name drugs have continued to rise in price and exceed inflation. These 25 drugs are responsible for $80.9 billion in total Part D spending in 2021. |

Medicare

California files suit against PBMs over insulin prices

Health Care Dive

JANUARY 13, 2023

The state filed suit Thursday against pharmacy benefit managers CVS Caremark, Express Scripts and OptumRx, alleging they worked with drugmakers to drive up the price of insulin.

Ohio AG sues ‘modern gangsters’ Cigna, Humana for alleged PBM price fixing

Health Care Dive

MARCH 28, 2023

Ohio Attorney General David Yost filed suit on Monday against the payers' PBMs, along with Prime Therapeutics, for allegedly sharing pricing information and driving up drug prices.

Can price transparency drive down health costs? The jury is still out

Fierce Healthcare

JULY 11, 2023

Price transparency has been a key focus for policymakers looking to address rising health costs, but experts say breaking through that black box won't solve the problem wholesale.

Merck sues to stop Medicare negotiation of drug prices

Health Care Dive

JUNE 6, 2023

The drugmaker’s lawsuit claims the new pricing powers granted by the Inflation Reduction Act are unconstitutional and “tantamount to extortion.”

Medicare

Medicare to collect drug price rebates starting in 2025

Health Care Dive

FEBRUARY 10, 2023

The CMS has laid out how it plans to implement a key provision of the Inflation Reduction Act requiring drugmakers to pay rebates on price hikes in Medicare that are greater than inflation.

Medicare

PBM, pharma play blame game over drug pricing at hearing

Fierce Healthcare

MAY 10, 2023

PBM, pharma play blame game over drug pricing at hearing pminemyer Wed, 05/10/2023 - 16:10

Pharmacies and wholesalers, not just PBMs, rely on spread pricing

Fierce Healthcare

OCTOBER 19, 2023

A new study released in JAMA Health Forum quantified how pharmacies and wholesalers use spread pricing to earn profit. Of the $11.8 billion spent on 45 generic drugs by Medicare Part D in 2021, 70% went to intermediary gross profit, according to a new study. |

Medicare

Cross-country comparison in health care price growth: 2000-2020

Healthcare ECONOMIST

MARCH 26, 2024

How did health care prices change over the past 2 decades. That is the question a paper by Papanicolas (2024) aims to answer, comparing US prices to those from Australia, Canada, France, and the Netherlands between 2000 and 2020. Before we get to the results, we first need to determine what types of price indices are out there?

Medicaid

Medicaid Medicare Healthcare

Senate Finance Committee votes to impose drug pricing standards on PBMs

Fierce Healthcare

JULY 26, 2023

In a largely harmonious Senate Committee on Finance markup hearing, members supported bipartisan efforts to rein in pharmacy benefit managers (PBMs) that they say operate without transparency to dr | The Senate wants to improve transparency surrounding pharmacy benefit managers and bring down prescription drug prices for the average person.

'Podnosis': Price transparency and Q1 financial trends

Fierce Healthcare

JUNE 6, 2023

This week on "Podnosis," you'll hear from Ge Bai, a Johns Hopkins health policy and economics researcher, who will chat about her work exploring healthcare prices. | 'Podnosis': Will price transparency move the needle on rising healthcare prices and Q1 financial trends

Healthcare

After years of decline, drugmakers' price hikes may have bottomed out

Health Care Dive

JANUARY 5, 2022

Inflation in 2021 may have offered drugmakers a catalyst for taking slightly bigger increases on a list price basis. But rebates to insurers are still keeping net price rises lower.

Site that lets consumers compare hospital prices goes live

Health Care Dive

MARCH 15, 2022

Turquoise Health's online search platform lists prices for medical procedures and services and offers a scorecard rating the transparency efforts of nearly 6,000 hospitals.

Hospitals

Report: Hospitals, payers making strides on price transparency compliance

Fierce Healthcare

APRIL 18, 2023

Report: Hospitals, payers making strides on price transparency compliance dmuoio Tue, 04/18/2023 - 09:49

Hospitals

FTC to vote on investigation into PBMs' drug pricing practices

Health Care Dive

FEBRUARY 17, 2022

The agency's commissioners will weigh Thursday whether to investigate PBMs and their relationship to drug prices and "practices that may disadvantage independent or specialty pharmacies," according to the meeting agenda.

Senate panel advances bill that would ban spread pricing

Fierce Healthcare

MAY 11, 2023

Senate panel advances bill that would ban spread pricing pminemyer Thu, 05/11/2023 - 12:40

Private insurer analysis uncovers geographic price variations

Fierce Healthcare

OCTOBER 30, 2023

and prices were the highest in the upper Midwest and Southeast, according to health payer Humana’s negotiated rat | In a first-of-its-kind study, researchers found that the cost of patient office visits varied by region, with the highest costs typically in the upper Midwest and Southeast.

NYSE tells Amwell to increase share prices or be delisted

House price transparency legislation passes with bipartisan support

Trending Sources

Foo Fighters to expose 'the pretenders' in price transparency concert

Hospital price transparency compliance dips: report

Price transparency startup Turquoise Health picks up $30M series B funding

Hospital, payer price transparency compliance improves, but new requirements are kicking in this year

More hospitals, payers compliant with price transparency laws

CVS Health revamps pharmacy reimbursement model amid scrutiny on high drug prices

US sues Regeneron, alleging false price reporting on Eylea

House committees introduce new healthcare price transparency legislation

2024 Outlook: Drug price negotiations, Braidwood highlights top legal cases to watch

New Walgreens CEO signals pharmacy giant will shift to new drug pricing models

Hospital M&A studies highlight higher prices, tepid antitrust intervention

Astellas withdraws lawsuit challenging Medicare drug price program

Hospitals share differing medical prices online versus over the phone, secret shopper survey finds

Certainly, a free booking platform with upfront prices, clinches $2.3M

Biden administration flags dozens of pharma companies to pay Medicare rebates for 'outrageous' price hikes

Hospitals' online and over-the-phone cash prices rarely align, study finds

FTC sues PE-backed anesthesia provider for monopolistic roll-ups, price setting

The legal battle over drug price negotiations is just getting started

Price transparency proposal leaves room for improvement, experts say

Physician-owned hospitals' negotiated, cash prices lower than nearby facilities, study finds

Boehringer sues to block US drug price program

AARP court brief backs Medicare price negotiation program

Lawsuit accuses Advocate Aurora of charging ‘eye-watering’ prices

Healthcare cost growth trails overall price hikes amid record inflation

Major hospitals still noncompliant with price transparency rules

Here are 25 Medicare Part D drugs that have skyrocketed in price

California files suit against PBMs over insulin prices

Ohio AG sues ‘modern gangsters’ Cigna, Humana for alleged PBM price fixing

Can price transparency drive down health costs? The jury is still out

Merck sues to stop Medicare negotiation of drug prices

Medicare to collect drug price rebates starting in 2025

PBM, pharma play blame game over drug pricing at hearing

Pharmacies and wholesalers, not just PBMs, rely on spread pricing

Cross-country comparison in health care price growth: 2000-2020

Senate Finance Committee votes to impose drug pricing standards on PBMs

'Podnosis': Price transparency and Q1 financial trends

After years of decline, drugmakers' price hikes may have bottomed out

Site that lets consumers compare hospital prices goes live

Report: Hospitals, payers making strides on price transparency compliance

FTC to vote on investigation into PBMs' drug pricing practices

Senate panel advances bill that would ban spread pricing

Private insurer analysis uncovers geographic price variations

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