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Most Medicare demonstration projects haven't saved money

Most of the Medicare fee-for-service demonstration projects launched in the past two decades using disease management and value-based payments have failed to reduce costs, says a report issued yesterday by the Congressional Budget Office.

5 percent of patients account for nearly half of U.S. healthcare spending

Five percent of patients account for nearly half of U.S. healthcare spending, according to a new report by the Agency for Healthcare Research and Quality.

NH battles with hospitals over Medicaid reimbursements

Tuesday is not just primary day in New Hampshire, it’s also when the State Supreme Court will hear arguments in the case of Dartmouth-Hitchcock Medical Center vs. Nicholas Toumpas; Toumpas being the commissioner of New Hampshire’s Department of Health and Human Services.

DOJ joins lawsuit against national for-profit hospice

The United States Justice Department has joined a whistleblower case alleging that a national chain of for-profit hospices violated the False Claims Act by spending millions of taxpayer dollars to care for Medicare recipients in hospice who were not terminally ill.

Incentives position payers for HIE success

Michael Dermer, CEO IncentOne

When the state health insurance exchanges (HIX) come online in 2014, the insurance industry will begin to shift from a B2B market to one that includes B2C. The Affordable Care Act will allow individuals and small businesses to buy coverage through these online insurance marketplaces at the state level. As such, participants likely will buy on value, and health plans will need to stand out from the many options available to members, while also remaining price competitive.

Avoid loaded words in healthcare debate

Paul Keckley, Executive Director, Deloitte Center for Health Solutions

In the 1952 Florida Senate race, George Smathers campaigned against incumbent Claude Pepper in the democratic primary, using this characterization attributed by journalists of the day as key to his win:

"Are you aware that the candidate is known all over Washington as a shameless extrovert? Not only that, but this man is reliably reported to have practiced nepotism with his sister-in-law... He matriculated with co-eds at the University, and it is an established fact that before his marriage he habitually practiced celibacy."

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CMS' Tavenner presses to scale innovations by 2014

Marilyn Tavenner, acting administrator for the Centers for Medicare & Medicaid Services, expressed urgency in pressing forward with the “triple aim” goals of better individual health care, better population health and lower costs called for in the health reform law and translated into initiatives by her predecessor.

ACP releases national healthcare report and argues for SGR repeal

The healthcare industry is making progress but is being held back by a broken political structure, said American College of Physicians leadership Thursday in a live web broadcast reviewing its State of the Nation’s Health Care report.

Healthcare in Florida: A reform laggard with much to gain

In addition to being the sole state named on the moniker Florida et al vs. U.S. Department of Health and Human Services case that the Supreme Court will hear in late March, Florida is one of four states trailing the most on health reform.

With ranks of insured at 94.2 percent, Massachusetts turns focus to costs

A new report published online in the journal Health Affairs showed that 94.2 percent of the non-elderly population in Massachusetts had health insurance, a significant increase over the 86.6 percent who were insured prior to the state’s health reforms.

Majority of Americans think ideology will affect SCOTUS ruling on health law

With the Supreme Court just two months away from hearing a historic legal challenge to the 2010 health law, nearly 60 percent of the public expects the justices to depend more on personal ideology than a legal analysis of the individual mandate, according to the Kaiser Family Foundation's January health tracking poll.

WellPoint blames senior business for its Q4 earnings miss

WellPoint Inc., the largest for-profit health insurer in the country, reported 2011 fourth quarter earnings 39 percent below 2010 Q4 earnings, largely due to increased medical expense in its Medicare Advantage business.

What Obama and Daniels said about healthcare

Neither President Obama, in his State of the Union Address, nor Indiana Governor Mitch Daniels, in his Republican response, said very much about healthcare.

mHealth apps help with medication adherence

One of the critical challenges to the successful adoption of patient-centered healthcare is ensuring that the patient adheres to his or her medication requirements. This means taking the right mediation in the right dose at the right time, with the right outcomes.

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Introducing HIMSS Payer Initiative -- Linking Payers and Providers to Improve the Quality of Care through IT

Recent healthcare policy changes, in conjunction with ever advancing health and health information technologies, are facilitating this country's movement toward the trifecta goal of improving the quality of patient care and outcomes while reducing costs. The payer community is an important and large healthcare stakeholder, and has a core expertise in facilitating the goal of "value."