Contributor: Bill Melville
Topic: CO-Ops, healthcare reform, exchanges

Every initiative in the Affordable Care Act has its detractors, but Consumer-Operated and Oriented Plans arguably receive the broadest disdain. The startup loans the Department of Health and Human Services awarded in 2012 felt a bit like money thrown away because many CO-OP sponsors were unknown entities. Loosely modeled on successful CO-OPs like Group Health Cooperative, which has 600,000 members in Washington and Idaho, the plans were meant to boost competition and give consumers a new choice in state health insurance markets.

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Contributor: Sheri Sellmeyer
Topic: ACOs, ACA, Medicare, Medicaid

Accountable care organizations are a big, new experiment with few results to show yet, but one in Nashville threw a party this week to celebrate its early success metrics and announce a partnership with the state’s largest insurer.

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Contributer: Joel Peyton
Topic: Medicare, Star ratings

Every few years, it seems, commentators predict the end of the world will occur at a certain date. Each time, the date passes and the world keeps turning. Much like those apocalyptic predictions, when the Centers for Medicare & Medicaid Services announces significant changes to the popular Medicare Advantage program, lobbyists and insurers decry the changes and say that the program modifications will result in skyrocketing premiums and dwindling benefits, with some even predicting the eventual demise of Medicare Advantage.
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Contributor: Sarah Wilson
Topic: Hospitals, health systems, mergers and acquisitions, antitrust

Last week, the Supreme Court unanimously voted to block Phoebe Putney Health System’s acquisition of former HCA-owned Palmyra Park Hospital, the only competitor in the Albany, Ga., market.
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Contributor: Mark Cherry
Topic: Florida, Medicaid, states, governors, ACA, exchanges

 For healthcare industry watchers, the "will-they, won't-they" decisions of each state's Medicaid expansion decision have been as exciting as the NFL Draft or National Signing Day for college football. Rather than thinking about team needs, the real focus is on these quasi-celebrities that have the potential for greatness, whose single decision affects the lives of millions. The late Wednesday rumors of Florida Gov. Rick Scott's press conference to accept Medicaid expansion shivered through my Twitter feed, as if a highly touted recruit was about to announce his choice between Alabama and Ohio State.

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Contributor: Chris Lewis
Topics: PBM, care management, specialty drugs, employers

There are two ways to get a good scare in Las Vegas. You can either ride the roller coaster that hovers above the New York New York casino, or you can sit in on the presentations at the Pharmacy Benefit Management Institute conference.
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Contributor: Jenny Kerr
Topic: ACA, physicians, narrow networks

Last week, the Federal Trade Commission granted a Norman, Okla., physician hospital group rare approval to negotiate with payers collectively. The FTC said the Norman Physician Hospital Organization’s proposal to transition to a clinically integrated network from a messenger model would provide better quality care and reduce costs. This benefit, it said, outweighed the fact that the PHO could now collectively negotiate higher prices because care coordination would require more physician resources.

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Contributor: Jane Dubose
Topic: Medicaid, medical homes

A recent report on patient engagement and a separate audit of North Carolina’s famed Medicaid medical home program illustrate just how difficult it is to reach solid conclusions on the value of patient-centered medical homes.
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Contributor: Chris Clancy
Topic: Healthcare reform

The U.S. Conference of Catholic Bishops on Feb. 7 issued its official response to the White House’s latest compromise regarding the so-called contraception mandate under the Patient Protection and Affordable Care Act. The organization said that the compromise “shows some movement by the Administration but falls short of addressing U.S. bishops’ concerns.”

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Contributor: Laura Beerman
Topic: Mergers and acquisitions, ACA

Remember the financial meltdown? Sure you do. Who could forget the fall of the house of irrational exuberance? Andrew Ross Sorkin captured the zeitgeist in his best-seller Too Big to Fail. From Lehman Brothers to AIG, the size and interdependence of the world’s most powerful financial institutions brought modern finance to its knees. For a CFO to look up from the balance sheet and realize there was less than 30 days of cash on hand had to be terrifying.

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