Medical Organizations Push Back On Anthem’s Out-Of-Network Policy
Anthem's plan would punish hospitals and outpatient facilities for using out-of-network providers. Also in health industry news: Sutter Health announces plans for a California hospital; which hospitals will take the hardest hits from the Medicaid cuts; and more.
Fierce Healthcare:
Medical Orgs Press Anthem To Pull Back Out-Of-Network Policy
Three major medical organizations are urging Anthem to withdraw a policy that would penalize hospitals and outpatient facilities that use out-of-network providers. The American Society of Anesthesiologists, American College of Emergency Physicians and American College of Radiology sent a joint letter to the insurer calling for it to rescind the policy, calling it "deeply flawed and operationally unworkable." (Minemyer, 11/17)
More health industry news —
San Francisco Chronicle:
Sutter Health Plans Major New South Bay Hospital
Sutter Health plans to open a major new hospital in Santa Clara by 2031, the provider announced Monday. The eight-story, 850,000-square-foot facility from one of Northern California’s largest hospital systems will include 272 beds, an emergency department, intensive care unit, labor and delivery department and other services. It will be located at 2831 and 2841 Mission College Blvd. near Levi’s Stadium, and replace an existing office park. (Ho, 11/17)
Modern Healthcare:
Hospital-At-Home Waiver Uncertainty Remains After Shutdown
Health systems are reevaluating hospital-at-home programs in the aftermath of the government shutdown. Providers are delaying the start of programs on hold, delaying expansions of existing ones and trying to find other ways to deliver acute-level care to people where they live. Stopgap legislation signed into law last week continues the Centers for Medicare and Medicaid Services Acute Hospital Care at Home waiver until the end of January. (Eastabrook, 11/17)
The New York Times:
When The G.O.P. Medicaid Cuts Arrive, These Hospitals Will Be Hit Hardest
Republicans created a special $50 billion fund to help rural hospitals stay afloat, but the biggest impacts may be in cities. (Badger, Parlapiano and Sanger-Katz, 11/18)
The Wall Street Journal:
Medicaid Insurers Promise Lots Of Doctors. Good Luck Seeing One.
Late on a cold afternoon in March, a motorist in Belleville, Ill., came upon a young boy wandering down a busy street without shoes and wearing only a T-shirt and pajama bottoms. She called the police. It was at least the fourth time in less than a year that then 8-year-old Trent Davis, who has autism and attention-deficit hyperactivity disorder, had run away from home, police reports show. (Weaver, Wilde Mathews and McGinty, 11/17)
Becker's Hospital Review:
Healthcare Wage Gaps Narrowed After COVID-19: Study
U.S. healthcare wage disparities modestly narrowed during the COVID-19 pandemic, according to a new analysis of wage data. The study, published Nov. 3 in Health Affairs, examined data from the Current Population Survey to identify trends in median earnings among healthcare workers between 2015 and 2024. (Gooch, 11/17)
KFF Health News:
Ticked Off Over Preauthorization: Walk-In Patient Avoided Lyme Disease But Not A Surprise Bill
Leah Kovitch was pulling invasive plants in the meadow near her home one weekend in late April when a tick latched onto her leg. She didn’t notice the tiny bug until Monday, when her calf muscle began to feel sore. She made an appointment that morning with a telehealth doctor — one recommended by her health insurance plan — who prescribed a 10-day course of doxycycline to prevent Lyme disease and strongly suggested she be seen in person. So, later that day, she went to a walk-in clinic near her home in Brunswick, Maine. (Sausser, 11/18)
