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Large health systems say the CMS's efforts to make MACRA less burdensome on small providers leaves them behind and they're suggesting the agency overhaul how the new payment model tracks physician performance to make it easier. Providers expressed the concern in comments to the CMS. The agency asked for that feedback on the interim final rule for the second year of the Medicare Access and CHIP Reauthorization Act. (Dickson 1/4)

Profits at the more than 4,800 U.S. community hospitals rose 3.8% in 2016, climbing to $76.1 billion, from $73.3 billion a year earlier. The trend follows years of steadily increasing profits. Total net revenue reached $979 billion in 2016—including nursing home results—and expenses were $903 billion, according to the 2018 edition of the American Hospital Association's Hospital Statistics report aggregating hospital financial and utilization trends, which was released Thursday. The annual report includes data on all 4,840 registered community hospitals in the U.S.—159 fewer than in 2012. (Bannow, 1/4)

Health insurers paid nearly $447 million in customer rebates for 2016 under a federal rule requiring payers to spend a minimum percentage of their premium dollars on medical care and quality improvement, the CMS said last week. Those rebates issued under the medical loss ratio provision of the Affordable Care Act went to 3.9 million consumers enrolled in individual and employer-based health insurance coverage for 2016. (Livingston, 1/4)

Highly regulated sectors, such as government offices and public health institutions, are most at risk of compromise as a result of the security flaw present in modern microprocessors from Intel Corp., Advanced Micro Devices Inc. and other manufacturers, according to security experts. Widespread use of old computers and legacy components means software-based fixes being developed by companies like Microsoft Corp. may slow down already-aging systems. (Lanxon and Kahn, 1/4)

CVS Health Corp. and Aetna Inc. were both talking to other potential partners during early discussions that led to their $68 billion merger, according to a regulatory filing Thursday. As late as August, Aetna was in discussions with a “Party X” about a “strategic partnership, business combination or other opportunities.” The mystery company, which isn’t named in the document, told Aetna in October that it wasn’t planning to make a takeover offer. (Tracer and Langreth, 1/4)