MONTH BY MONTH

Modern Healthcare - - NEWS -

JAN­UARY

CMS lead­er­ship switch: CMS chief Mar­i­lyn Taven­ner re­signs and Andy Slavitt be­comes act­ing ad­min­is­tra­tor.

Co-op plan crash: Iowa or­ders not-for-profit ACA co-op in­surer CoO­por­tu­nity Health to shut down.

Fee-for-ser­vice phase-out: HHS pledges that by 2018, half of Medi­care spend­ing out­side of man­aged care will be fun­neled through value-based pay­ment mod­els.

Hoosier ex­pan­sion: In­di­ana Repub­li­can Gov. Mike Pence an­nounces his state won fed­eral ap­proval for its Med­i­caid ex­pan­sion plan.

FE­BRU­ARY

Mil­lions hacked: An­them an­nounces that hack­ers have in­fil­trated its IT sys­tem and ac­cessed the per­sonal in­for­ma­tion of 80 mil­lion mem­bers.

Con­sol­i­da­tion set­back: A fed­eral ap­pel­late court backs a lower court or­der for St. Luke’s Health Sys­tem in Idaho to un­wind its ac­qui­si­tion of a large physi­cian group on an­titrust grounds.

Sign-up progress: The ACA’s sec­ond en­roll­ment pe­riod closes with more than 10 mil­lion en­rollees.

APRIL

In­surer vic­tory: CMS boosts av­er­age Medi­care Ad­van­tage base­line pay­ment rates by 1.25% for 2016.

SGR junked: Congress passes bill re­peal­ing the Medi­care SGR for­mula and es­tab­lish­ing a new physi­cian pay­ment sys­tem.

See­ing stars: The CMS’ qual­ity star-rat­ing sys­tem for hos­pi­tals is un­veiled, with 251 fa­cil­i­ties get­ting the top five-star score.

MAY

Med­i­caid plan rules: The CMS pro­poses sweep­ing Med­i­caid man­aged-care rules, in­clud­ing min­i­mum med­i­cal-loss ra­tios.

JUNE

Sub­si­dies saved: The U.S. Supreme Court upholds the ACA’s pre­mium sub­si­dies.

JULY

More merger ma­nia: Aetna an­nounces it will pay $37.1 bil­lion for Hu­mana.

Medi­care ini­tia­tives: The CMS pro­poses pay­ing for end-of-life coun­sel­ing.

Planned Par­ent­hood sting: Anti-abor­tion activists release an un­der­cover video show­ing a se­nior Planned Par­ent­hood of­fi­cial discussing aborted fe­tuses be­ing used for re­search.

Mil­i­tary bo­nanza: Cerner Corp. and Lei­dos win $4.3 bil­lion Mil­i­tary Health Sys­tem health IT con­tract.

Mon­ster merger: An­them an­nounces deal to ac­quire Cigna worth $54.2 bil­lion.

AU­GUST

Strat­egy shift: Com­mu­nity Health Sys­tems says it will shed 38 hos­pi­tals and shift fo­cus to large mar­kets and re­gional net­works.

Tur­ing point: Tur­ing Phar­ma­ceu­ti­cals ac­quires generic drug Dara­prim and hikes price by more than 5,000%.

SEPTEM­BER

An­other ACA law­suit: Fed­eral judge grants House Repub­li­cans le­gal stand­ing to seek fund­ing cut­off on cost-shar­ing sub­si­dies for ex­change plan mem­bers.

Stark set­tle­ment: Ad­ven­tist Health Sys­tem dis­closes it will pay $118.7 mil­lion to set­tle al­le­ga­tions it of­fered doc­tors ex­ces­sive com­pen­sa­tion for re­fer­rals.

Fraud set­tle­ment: The U.S. Jus­tice Depart­ment an­nounces set­tle­ment with hun­dreds of hos­pi­tals re­sult­ing from a probe into al­leged overuse of im­plantable car­dioverter de­fib­ril­la­tors.

OC­TO­BER

Smooth launch: Hos­pi­tals and other health­care or­ga­ni­za­tions im­ple­ment the new ICD-10 cod­ing sys­tem with few re­ported hitches.

Ex­change pre­mi­ums up: HHS re­ports that 2016 av­er­age pre­mi­ums for bench­mark sil­ver plans will in­crease by 7.5%.

NOVEM­BER

Ken­tucky switches horses: Repub­li­can Matt Bevin elected gov­er­nor af­ter vow­ing to roll back the state’s Med­i­caid ex­pan­sion and junk its suc­cess­ful in­sur­ance ex­change.

Man­dated bundling: The CMS fi­nal­izes a rule re­quir­ing hos­pi­tals in 67 mar­kets to par­tic­i­pate in a test of bun­dled pay­ments for joint re­place­ments.

Ex­change bomb­shell: Unit­edHealth Group an­nounces big losses on its in­sur­ance ex­change busi­ness and threat­ens to exit the ex­changes in 2017.

Pharma merger: Drug­maker Pfizer of­fers $160 bil­lion to buy Ire­land-based Al­ler­gan in a deal that will re­duce Pfizer’s U.S. taxes.

DE­CEM­BER

Not-for-profit merger: Kaiser Per­ma­nente an­nounces it will ac­quire Seat­tle-based Group Health Co­op­er­a­tive, ex­pand­ing Kaiser’s ge­o­graphic reach.

Sym­bolic re­peal: Se­nate Repub­li­cans pass bill re­peal­ing most of the Af­ford­able Care Act, which the pres­i­dent is cer­tain to veto.

ACA fund­ing freeze: Con­gres­sional lead­ers un­veil bi­par­ti­san tax pack­age freez­ing the ACA’s taxes on Cadil­lac plans, med­i­cal de­vices and health in­sur­ance.

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