All signs point to value-based care: Are you ready?

Daniel Finke, Aetna

With the current shift to value-based reimbursement, providers are facing noteworthy changes as healthcare consumers are under more financial pressure than ever before.

Setbacks and successes: What we've learned from the first year of commercial risk adjustment

Sean Creighton, Verisk Health

Qualified health plans completed their first year of commercial risk adjustment reporting and the Centers for Medicare & Medicaid Services reported the results.

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The Obama Administration recruited Seattle Seahawks quarterback Russell Wilson and cornerback Richard Sherman to the game of selling the Affordable Care Act.

President Obama acknowledges the technical issues with HealthCare.gov, pledging his Administration will resolve them soon and asserting that the distressed web portal is not the only way to shop for affordable health insurance available through the ACA.


Three years after launching a 750-patient Medicare Advantage collaborative care pilot, Portland, Maine-based independent physician practice NovaHealth and insurer Aetna have shown concrete results in improving care quality and reducing costs. Technology and provider-payer cooperation played a large part in the program's success.

New Hampshire hospitals Dartmouth-Hitchcock, Elliot Health System and Frisbie Memorial Hospital are joining with Harvard Pilgrim Health Care to create a new analytics company to manage the clinical and financial data across the organization.

Chronically ill people enrolled in individual health plans sold on the Affordable Care Act insurance exchanges pay on average twice as much out-of-pocket for prescription drugs each year than people covered through their workplace, according to a study published Monday in the Health Affairs journal.

While the Supreme Court decision in King v. Burwell that cleared subsidized health insurance premiums under the Affordable Care Act removed a lot of uncertainty from hospital finance, little has changed when it comes to hospitals' access to debt. But that may change.

On Thursday, providers dealt with system issues, which will be followed by productivity issues and then payment issues, according to healthcare insiders.

Healthcare Finance spent the bulk of Thursday's rollout monitoring the buzz, speaking with experts and reporting on any issues that may have arrived. While the true effects of the change will be felt in the coming weeks when claims are processed, bills delivered and accounts receivable wane, we have a few observations to share.

Insurance companies will pay $362 million to the federal government's shared risk program beginning this November for 2014 participation, but will be short $2.5 billion in payments that they hoped to receive from the federal government, the Department of Health and Human Services announced on Thursday.

Healthcare IT News and sister site Healthcare Finance will be reporting on the changeover throughout the day, using the live blog below to highlight the latest news, real-time reactions and frequent updates from our cadre of volunteer ICD-10 correspondents.

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