Health Insurers To Pay Record Rebates After Individual Market Stabilizes

A new report from the Kaiser Family Foundation shows that insurers are more profitable than ever, and are expected to pay around $800 million in rebates to individual market consumers, a record since the passing of the Affordable Care Act. The insurers did not meet the ACA medical loss ration threshold, which requires 80 percent spending of premium revenues on healthcare claims or quality improvement activities. Though the early years of the ACA were often volatile and insurers reacted with increased premiums, by 2017 the individual market had stabilized, and premiums were expected to level out as well. But with… Full Story

Southwestern Medical Foundation Names Ho Din Award Winner

The  Southwestern Medical Foundation has given the Ho Din Award to Dr. Bethany Werner, recognizing her for her medical wisdom, human understanding, and compassion. Since 1943, the award has been the highest honor given to a UT Southwestern medical student. Werner graduated with honors from UT Dallas while playing for the volleyball team, was a manager and regular volunteer at the UTSW Office of Global Health’s Agape Clinic in medical school and directed a health fair. She will soon begin her residency in obstetrics and gynecology at UT Southwestern. “Through her compassionate spirit and academic devotion, Dr. Werner has embodied the vision… Full Story

Genesis Physicians Group Expands Value-Based Care with Population Health Partnership

Genesis Physicians Group has partnered with Innovista Health Solutions, a population health management organization owned by Health Care Services Corporation, Blue Cross Blue Shield of Texas’ parent company. The move will expand Genesis’ independent physicians ability to participate in better coordinated value-based care. The partnership is meant to reduce avoidable health care cost increases by combining Genesis’ experience as an independent physician association and Innovista’s industry expertise and population health technology. It will facilitate Genesis physicians transition to value-based care from the fee-for-service model. It will also improve coordination between primary care and specialist physicians. “Genesis and Innovista have come… Full Story

McKesson Corp. Saw Three Percent Revenue Growth in Fiscal Year 2019

Despite being in legal hot water in multiple states for the number of opioids McKesson Corp. sent to patients and doctors, the pharmaceutical giant reported a three percent increase for full-year fiscal 2019 revenue and two percent up from last year’s fourth quarter. The fourth quarter fiscal 2019 revenue was $52.4 billion, and the full year revenue was $214.3 billion. Shareholders received $1.9 billion due to share repurchases and dividends in fiscal year 2019. The company has a positive outlook looking forward due to a renewed pharmaceutical distribution relationship with CVS Health through 2023. McKesson’s cashflow was $4.0 billion for… Full Story

North Texas Leads on Medical Marijuana and E-Cigarette Legislation

Fort Worth Republican Rep. Stephanie Klick’s bill to expand medical marijauna coverage has passed the Texas House of Representatives by a vote of 133-10, and will head to the Senate where it will be debated further. Klick’s bill was accompanied by another more expansive medical marijauna bill authored by Brownsville Democrat Rep. Eddie Lucio III, which also passed by an overwhelming majority. Currently, Texas’ Compassionate Use Act says that intractable epilepsy is the only condition that can be legally treated by cannabis with low levels of THC. Klick, a nurse, is the author of the 2015 Compassionate Use Act. But the… Full Story

Two North Texas Docs, One Nurse Sentenced to Federal Prison in Opioid Case

The healthcare professionals were sentenced to federal prison last week for illegally distributing opioids and other controlled substances in the Eastern District of Texas. After pleading guilty last October, Dr. Howard Gregg Diamond, a Sherman physician, received a 20-year sentence for conspiracy to possess with intent to distribute controlled substance and 10 more years for health care fraud. Diamond began writing fraudulent prescriptions for hydrocodone, fentanyl, oxycodone and other opiates in 2010 from his pain management offices in Sherman and Paris, Texas. In 2014, an individual died after taking morphine, oxycodone, alprazolam, and zolpidem that Gregg distributed. Court documents also show… Full Story

Healthcare Fraudsters Steal $1.1. Million Per Case, Outpacing Other Industries

Dallas was home to the largest healthcare fraud case in the country this year, as guilty verdicts came down for a number of defendants in federal court for $200 million worth of fraud in the Forest Park Medical Center case. Data from the Association of Certified Fraud Examiners shows that when owners and executives commit fraud, healthcare executives take even more than other industries. Healthcare fraud adds to the healthcare costs of everyone, as insurance companies and employers that make fraudulent payments have to get that money from somewhere, often resulting in increased premiums that have contributed to the country’s skyrocketing… Full Story

How Much are Patients Paying to Deliver Babies in Dallas?

In the Dallas area, new moms will find a nearly $5000 range in price range to deliver their baby. As healthcare costs continue to rise, price transparency has become a key strategy for those trying to bring high prices and the stress they put on the system under control. Hospitals are now asked to post their prices online, but most are difficult to interpret and somewhat meaningless unless one knows how their insurance deductible and coinsurance will impact the final cost. The Robert Wood Johnson Foundation funded the Healthy Marketplace Index, where they analyzed negotiated rates between providers and insurance… Full Story

JPS Health Network Expands Its Oncology and Infusion Center

JPS Health Network has opened a 50,170 square-foot Oncology and Infusion Center to provide more space for cancer patients that need those services. The facility will also include a nutritionist, psychological services, a surgical oncologist, an on-site pharmacy and an office for the JPS Cancer Survivors Clinic. Dr. Bassam Ghabach, director of the Oncology and Infusion Center, says that 38 percent of cancer patients who seek treatment at JPS are in Stage III or IV when diagnosed, but the new center will allow more space for earlier detection and increased likelihood to beat the cancer. Oncology visits have increased by… Full Story

New Rules for Safety Net Hospitals Reduce Readmission Penalties, UTSW Research Shows

In order to reduce health system costs nationwide, legislation created penalties for hospitals if patients are readmitted within a certain time frame after being treated, but new research from UT Southwestern Medical Center reveals that a rule adjustment  is causing penalties to drop for hospitals that treat riskier patients. Hospitals such as Parkland that care for socioeconomically disadvantaged patients are more likely to have patients who leave the hospital and go back to unstable environments where they can’t or don’t follow doctor’s orders closely, which can result in a return of symptoms. Patients may have transportation hurdles that keep them… Full Story