A new analysis of more than 3 million claims for Medicare patients found that patients enrolled in a managed Medicare Advantage plan had better health outcomes than those senior enrolled in the traditional fee-for-service Medicare model. Read more »
With recognition that "the path through accountable care is unknown," Read more »has launched a new Accountable Care Maturity Model, designed to help healthcare organizations gauge their own status and make strategic decisions for funding business and IT initiatives.
One of the principal arguments for passing healthcare reform legislation circled around the theory of cost shifting. In essence, when hospitals care for uninsured patients that don't pay bills, or when they receive low reimbursements for Medicare or Medicaid patients, they charge insurers higher fees to make up for the losses. Read more »
The American Orthotic and Prosthetic Association (AOPA) is suing the Department of Health and Human Services over 2011 rule changes for prosthetic reimbursements requiring physician documentation, which the association claims is wreaking financial havoc on O&P practitioners due to prepayment audits and retroactive application. Read more »
A Google search for "health insurance" brings eHealthInsurance.com as one of the top results -- one reason, eHealth executives say, that state exchanges should follow the federal government in allowing consumers to enroll in subsidized health plans through private web exchanges like eHealthInsurance. Read more »
As the GOP-controlled House of Representatives prepares again to vote this week on a repeal of the 2010 health law, some key Republican senators have seized on recent news developments to show their ire. Read more »
The Centers for Medicare & Medicaid Services (CMS) is looking to more than a dozen dual eligible demonstrations to fulfill the quality improvement and cost saving aims of the Affordable Care Act, although in the five demonstrations approved so far, the exact sources of projected savings remain largely unclear, according to the Kaiser Family Foundation. Read more »
That sigh of relief you heard Monday was from hospital administrators in nearly two dozen states, including Florida and Texas. Read more »
The number of health plans that expect more than half their business will be under value-based models is expected to triple in the next five years according to a new research report released last week by health information network Availity. Read more »
Cigna has announced that it will enlist the help of MDLIVE, a developer of Read more »technology and services, to offer eligible health plan members round-the-clock online video consultations with internal medicine, family practice and pediatric doctors.
Congressional Republicans are proposing new ideas for changing Medicaid, suggesting models based on the 1996 federal welfare reform law, and proposing a bill that would base federal allocations on population size and patient categories. Read more »
The U.S. Equal Employment Opportunity Commission (EEOC) is going to offer clarification on wellness programs and federal nondiscrimination compliance, after several business groups and disability advocates asked for guidance on the issue. Read more »
If Congress pursues tax reform in the near future, one tax expenditure likely to be considered and possibly adjusted is the exemption for employer-sponsored insurance — and it's about time, argue researchers at the Urban Institute. Read more »