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Morning Briefing

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Wednesday, Jul 31 2024

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CMS Raises Medicare Pay For Hospices By 2.9% In Fiscal 2025

The Centers for Medicare and Medicaid Services' final hospice provider reimbursement boost is higher than the 2.6% proposed in March. Also in health industry and pharma news: HealthPartners, Community Health Systems, Mount Sinai, Eisai, Biogen, and more.

Medicare reimbursements for hospice providers will increase 2.9% in fiscal 2025 under a final rule the Centers for Medicare and Medicaid Services issued Tuesday. That's higher than the 2.6% payment update CMS proposed in March and comprises a 3.4% increase in the market basket minus a 0.5 percentage point productivity adjustment. Hospice providers that do not report quality data will receive a 1.1% reimbursement cut. (Young, 7/30)

A shake-up between two health behemoths could affect 30,000 seniors across the state. HealthPartners recently announced it is dropping out of UnitedHealthcare’s Medicare Advantage network. That means starting next year, Medicare Advantage recipients through UnitedHealthcare will no longer be covered at certain HealthPartners clinics and hospitals. (Moini and Bui, 7/30)

Community Health Systems is selling its three Pennsylvania hospitals to WoodBridge Healthcare for $120 million. The deal, which is expected to close in the fourth quarter, includes 186-bed Regional Hospital of Scranton, 122-bed Moses Taylor Hospital in Scranton and 369-bed Wilkes-Barre General Hospital, for-profit CHS said Tuesday in a news release. Related facilities such as ambulatory surgery centers, emergency departments and outpatient rehabilitation sites are included in the sale. (Hudson, 7/30)

Mount Sinai, a leading hospital network in New York City, has mounted an extraordinary behind-the-scenes campaign to blunt the fallout over revelations about its controversial research project in which brain biopsies are taken from patients undergoing deep brain stimulation, STAT has learned. (Eban, 7/31)

Two days after Thanksgiving in 2022, Shannon Hanchett walked into an AT&T store for a new phone, and ended up in handcuffs. Hanchett ran the Cookie Cottage, a popular bakery in this college town, where she made treats named for places across the state, from Stilwell Strawberry to Lawton Lemon. But lately, her mental health seemed to be fraying. (Aspinwall, Bailey and McClendon, 7/31)

Lyla Abuebaid needs to check on her 5-year-old son through the night to make sure he keeps breathing. ... She is among thousands of Californians who have been trying to get Medicaid benefits for services to help medically vulnerable people remain at home through the Home and Community-Based Alternatives waiver. Demand for the HCBA waiver, which helps people who might otherwise have to live in nursing facilities, has far outstripped the available spots. (Alpert Reyes, 7/30)

Virtual care providers, particularly those providing behavioral health services, face stiff competition in their quest to become an in-network partner. Just how stiff? Ask Chris Daher, vice president of network development and provider relations at Magellan Health. Daher helps the managed care company vet potential behavioral health virtual providers and neither he nor the company takes the easy route. Magellan manages the behavioral health coverage for Blue Shield of California, the third-largest insurer in a state of 39 million people. (Perna, 7/30)

In pharma and tech news —

Patients with early Alzheimer’s disease treated with a medication developed by Eisai and Biogen for up to three years experienced less cognitive decline than what’s expected of untreated patients based on historical data, according to new study results reported Tuesday. The manufacturers said the data support long-term, continuous use of the drug. (Chen and Feuerstein, 7/30)

Since the Brockton Neighborhood Health Center opened its own pharmacy more than a year ago, the facility has acted as an oasis for a community that sorely lacks drug stores. As CVS, Walgreens, and Rite Aid closed hundreds of stores across the state in recent years, nonprofit community pharmacies like the one in Brockton — and others in Dorchester, South Boston, and Roxbury — have stepped up to fill the void. (Lee, Kohli and Woodard, 7/30)

In a boost for animal rights advocates, a U.S. appeals court ruled that a National Institutes of Health policy for monitoring comments posted to its online forums violated the First Amendment because the agency made a point of removing remarks about animal testing. (Silverman, 7/30)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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