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In 1982, Jim Hertel joined colleague Curt Barker in a managed care consulting venture, the HealthCare Computer Corporation of America. Curt left the venture, while Jim continued to consult with key health care companies throughout the United States for the next 10 years. In 1994, HCCA began a full-time focus on publishing data of interest to the Colorado healthcare industry with two key annual pu
blications: the Directory of Managed Care© and Competitive Analysis of the Healthcare Marketplace©. Jim’s understanding of managed care market analysis became the foundation for these popular data resources. In September 1994, the first issue of Colorado Managed Care© newsletter was published, tracking and reporting on events, market changes and the people of healthcare. In 1995, HCCA expanded into the Arizona market and published its first directory covering the healthcare industry the following year. The Arizona Managed Care Newsletter© followed in the spring of 1997. The newsletters continue to be published monthly in both markets. HCCA began a series of “State-of-the-State of Healthcare Financing” seminars for its newsletter readers to reinforce the company’s commitment to single-state-focused news and strategic information for health leaders. For both markets, the first of these semi-annual events was held in 1999. Their popularity continues to draw large gatherings of colleagues in both Arizona and Colorado. In May 2014, Jim Hammond of Professional Healthcare Solutions, LLC purchased the Arizona Managed Care Newsletter from HCCA and renamed it The Hertel Report. “The Hertel Report is pleased to continue the legacy of Jim Hertel and deliver timely, accurate, impartial data and other information to members of the Arizona healthcare industry. We will take the existing model of delivering information through a paper newsletter, emailed news listings, website and face-to-face meetings and make it better" says Hammond.
With the expansion in Medicare Advantage, Amazon said over 50 million more people will be eligible to use the service, known as RxPass, launched for U.S. Prime members in January 2023 for just $5 a month.
Amazon.com's pharmacy unit said on Tuesday it is expanding eligibility for its monthly subscription service, which covers a range of generic drugs, to those enrolled in government-backed Medicare insurance plans.
“As physicians we’ve taken an oath to care for our patients and ensure their best outcomes and do no harm. These bans directly oppose our oaths and the standards of science-based, data-driven medical care,” said Arizona’s Dr. Hiral Tipirneni, an ER doctor in Glendale during a recent news conference.
With the Supreme Court deciding whether federal law protects emergency room abortions, doctors are urging the court to preserve access
Steward has an estimated 2,000 employees in Arizona. "We write to ask that the U.S. Department of Labor ensure that Steward workers and retirees receive the health care and retirement benefits to which they are entitled. Workers and retirees must be protected from further harm resulting from Steward’s gross financial mismanagement," stated a group of Democratic members of Congress, led by Sen. Edward Markey of Massachusetts.
A group of Democratic members of Congress is seeking reassurances that workers at hospitals owned by Steward Health Care will have their health care and retirement benefits protected.
A federal judge ordered Arizona’s Department of Corrections, Rehabilitation and Reentry on Tuesday to completely fill vacant positions at two state prisons, dismissing arguments that the department lacks the funds necessary to comply with the order.
After a six-month pilot program in which only two of the 14 state prisons must reach 100% staffing, the Arizona Department of Corrections will be required to fill the remaining vacancies by a yet-to-be-determined date.
DSH NEWS: The U.S. Supreme Court announced this week it will review a lower court's ruling that restricts Medicare payments to hospitals serving a high proportion of low-income patients. This decision follows the U.S. Court of Appeals for the District of Columbia Circuit's September ruling favoring the Department of Health and Human Services. The case, initially brought forth by a coalition of 213 hospitals in 2017, was petitioned to the Supreme Court for review in December.
A group of 213 hospitals asked the Supreme Court in December to review disproportionate share hospital payment calculations.
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Arizona healthcare leaders, stay ahead of the curve! Get curated updates every Thursday at 5 am from The Hertel Report. Elevate your leadership, elevate your impact. Become a member today!
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Discover the power of data-driven decision-making with our Quarterly Arizona Data Editions! Gain valuable insights on Medicare Advantage, AHCCCS, hospitals and health systems, and ACOs. Become a member now during our spring membership drive!
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Arizona healthcare leaders, stay ahead of the curve! Get curated updates every Thursday at 5 am from The Hertel Report. Elevate your leadership, elevate your impact. Become a member today!
https://www.thehertelreport.com/spring-membership-drive-join-the-hertel-report/
Don't miss out on valuable insights! Join The Hertel Report for curated updates, exclusive data editions, conference discounts, and networking events tailored for Arizona healthcare professionals. Elevate your leadership, join now!
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Empower your leadership with knowledge! Join The Hertel Report for weekly updates on Arizona's healthcare trends and policies. Don't let complexities hold you back. Become a member today!
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❗️New Resource Alert! ❗️
Attention Arizona Healthcare Professionals! AHIP, AMA, and NAACOS have collaborated to develop an invaluable playbook focused on total cost of care (TCOC) models. Whether you're a physician, nurse, administrator, or policymaker, this playbook provides actionable strategies to drive positive change in healthcare delivery. Join us in leveraging these insights to enhance value-based care initiatives across our state – learn more at The Hertel Report. Together, let's build a healthier future for Arizona!
https://www.thehertelreport.com/insurers-physicians-providers-acos-release-playbook-to-advance-value-based-care/
Ready to harness the insights from Arizona's healthcare data? Our Quarterly Arizona Data Editions provide in-depth analysis on Medicare Advantage, AHCCCS, hospitals, and accountable care organizations. Don't miss out – join now during our spring membership drive!
https://www.thehertelreport.com/spring-membership-drive-join-the-hertel-report/
Calling all Arizona healthcare leaders! Stay informed with The Hertel Report's curated weekly updates. Get the latest on Medicare Advantage, Medicaid, hospitals & health systems, and more. Join now!https://www.thehertelreport.com/spring-membership-drive-join-the-hertel-report/
Read the Hertel Report for more details.
https://www.thehertelreport.com/oig-faults-cms-agency-did-not-ensure-ahcccs-complied-with-mental-health-sud-parity-requirements/
Stay ahead of the curve with our Thursday News Listing! Join our community of healthcare leaders and receive weekly curated insights into the top healthcare stories impacting Arizona and beyond. Don't miss out – sign up today during our spring membership drive!
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Discover the latest healthcare trends and developments with our Thursday News Listing! Get access to curated insights on the top stories impacting Arizona healthcare leaders. Sign up today to stay informed and ahead of the curve during our spring membership drive!
https://www.thehertelreport.com/
Tucson!
FREE Spring Tucson Networking Event TOMORROW!💢
Join Arizona MGMA, Arizona Medical Association, HFMA Arizona Chapter, and The Hertel Report in Tucson tomorrow at Culinary Dropout!🤝
Enjoy networking with your community, food, and drinks! We can't wait to see you all there!🥩🥦🥂
REGISTER: https://azmgma.org/event-5660241
Federal regulators launched an investigation last week probing private equity (PE) firms’ investment in healthcare, Modern Healthcare reported. The Federal Trade Commission, Justice Department and Health and Human Services Department want to know the effects of PE and other corporate investor-backed healthcare transactions. The agencies are concerned PE deals may generate profits for corporate investors at the expense of patients’ health, workers’ safety and affordable care.
The Federal Trade Commission is concerned private-equity backed deals may generate profits for those firms at the expense of patients’ health.
MODERN HEALTHCARE WOMEN LEADERS IN HEALTHCARE - 2024 Congratulations to Banner Health's Julie Ann Alvarado-Dubek EVP and chief human resources officer. Modern Healthcare’s Women Leaders program honors executives who are guiding healthcare delivery improvement across the country. The annual program recognizes individuals from all sectors of the industry, spotlighting their professional accomplishments and contributions to their organizations.
Hometown publications often have the best coverage - learn about Steward Health Care's rocky financial history and entanglements from D Magazine in Dallas, Steward's base of operations. Steward's Arizona hospitals include Florence Hospital, Mountain Vista Medical Center in Mesa, Tempe St. Luke's, and St Luke's Behavioral Health Center in Phoenix.
The Dallas-based system’s financial woes have made headlines following the pandemic and its former private equity owners’ $700 million exit.
Have Opinions About Private Equity's Role in Healthcare?
On March 5, 2024, the Department of Justice’s (DOJ’s) Antitrust Division, the Federal Trade Commission (FTC), and the Department of Health and Human Services (HHS) jointly issued a Request for Information (RFI) to solicit public comments about the impacts of consolidation in the healthcare industry. The agencies’ concerns focus on anticompetitive mergers and pricing strategies by private equity funds in the healthcare industry.
The Federal Trade Commission is concerned private-equity backed deals may generate profits for those firms at the expense of patients’ health.
ASU Med School to Open Fall 2026
The new school will be called the School of Medicine and Advanced Medical Engineering. ASU is taking an innovative approach with its new medical school by allowing students to complete two degrees: a Doctor of Medicine (M.D.) and a master’s degree in medical engineering.
Why It's Important: More than 2,000 PCPs are needed in the state to meet demand by 2030.
The Arizona Board of Regents has taken a significant stride toward improving health care for residents of Arizona by giving its formal approval for the establishment of a new medical school at Arizona State University. The school is slated to open in fall 2026. The move is a part of the AZ Healthy T...
It won't be the same without you! Register today for the 2024 Winter State of the State on February 16, 2024, at the Orange Tree Resort in Scottsdale. Our annual breakfast meeting is always a sell-out - register today!
Join us for The Hertel Report’s State of the State featuring our annual Arizona healthcare market update hosted and moderated by Publisher Jim Hammond. After breakfast and networking, this year’s panel of guest speakers will deliver the latest insight impacting managed care in Arizona. Prefer to...
Worth following from the Arizona Republic, "The Arizona Medical Board conceded a need for improvement following an Arizona Republic investigation that exposed the board’s shortcomings in its handling of doctor sexual misconduct claims. Yet at a Jan. 3 meeting where a board staff member presented options for change, the board also decided to leave in place doctors accused of sexual misconduct and violence."
While it conceded a need for some changes, the board at the same meeting left in place doctors accused of sexual misconduct and violence.
We're hitting refresh until CMS releases its 2024 January MA enrollment report, until then Aetna is reporting significant growth: 800k new members in 2024. In Arizona, CVS/Aetna's MA enrollment falls behind UnitedHealthcare and Humana. Last year about 43K Medicare eligibles chose an Aetna MA plan.
CVS Health exceeds expectations for Medicare Advantage growth in 2024 enrollment, driven by strong sales and retention of Aetna members.
ALTCS Contracts Awarded
The Arizona Health Care Cost Containment System has awarded contracts for long-term care services to two health plans, Arizona Complete Health-Complete Care and UnitedHealthcare Community Plan, effective October 1, 2024.
Five insurers bid for the ALTCS contract - those unsuccessful in their bid include two current ALTCS-EPD health plans, Mercy Care & Banner-University Family Care.
Learn more from AHCCCS:
PHOENIX – The Arizona Health Care Cost Containment System has awarded contracts for long term care services to two health plans, Health Net Access, Inc. (dba Arizona Complete Health-Complete Care Plan) and Arizona Physicians IPA, Inc. (dba UnitedHealthcare Community Plan), effective October 1, 202...
AHCCCS Fraudsters
The Currys submitted over $12M in claims for the purported treatment of approximately 185 patients through their outpatient behavioral health clinic located in Mesa. The Currys are charged with Wire Fraud and Money Laundering, conviction for Wire Fraud carries a maximum penalty of 20 years in prison and a fine of $250,000. A conviction for Money Laundering carries a maximum penalty of 10 years in prison and a fine of $250,000.
PHOENIX, Ariz. – Thvoughn Lynden Curry, 31, and his wife, Alexis Daneen Curry, 32, of New River, Arizona, were arrested on November 2, 2023, pursuant to a federal indictment charging wire fraud and money laundering.
This year's summer is a scorcher. Today's coverage from The Washington Post focuses on Phoenix as an example of the impact of extreme heat on our most vulnerable residents. A recent study from the British Columbia Centre for Disease Control found those with schizophrenia are more than 200% more likely to die during a heat wave. With 300 suspected heat-related deaths in Arizona this year, it makes you wonder why local officials from the Maricopa County Department of Public Health or the city's director of heat response didn't respond to questions from post reporters or why the city's heat response plan, "doesn't include any mentions of mental illness or schizophrenia."
People with schizophrenia and other mental health issues face heightened risk of death from extreme heat, growing research shows.
NYC Retirees Don't Want MA - Judge says they don't have to switch.
The Adams administration had intended to switch 250,000 retired public-sector workers to a controversial privately run health care plan on Sept. 1.
Too many MA choices can be a problem for seniors. Less than half of beneficiaries said they understood their plan, and half said, "kinda." Good coverage on a concerning topic.
Just 44% of MA beneficiaries said they fully understand their plan, while 50% say they "somewhat" understand it.
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