The growth rate of healthcare spending among those with private, employer-sponsored health insurance rose 4 percent in 2012, slightly lower than the previous year, but with more dollars spent on outpatient care and Read more »expenses, according to the Health Care Cost Institute.
The Centers for Medicare & Medicaid Services (CMS) issued a final rule on Medicaid payments to disproportionate share hospitals (DSH) last week, cutting approximately $1.1 billion from the program over the next two fiscal years. Read more »
Much of the marketing to potential enrollees of health insurance exchanges has been conducted by health insurers and other organizations advancing the marketplaces, but health systems have a role to play in signing up individuals that could also benefit their bottom line. Read more »
A group of physicians that want to offer new imaging and colonoscopy services in Virginia are trying to overturn the commonwealth's certificate of need law but face an uphill battle with a new legal argument. Read more »
Insuring more people as a direct result of the Affordable Care Act will bump up national health spending in 2014 to a 6.1 percent growth rate, according to the Centers for Medicare & Medicaid Services. But for private health insurance, the spending growth rate will more than double. Read more »
Cigna will begin using MyFitnessPal's nutrition, physical activity and weight management platform to enhance its coaching programs. It's a way for the payer to support and meet members where they are as they try to manage their health. Read more »
Governor Rick Snyder has signed the Healthy Michigan plan into law, making nearly half a million more residents eligible for the state's version of Medicaid expansion, to improve what he described as a combination of cost, quality and access. Read more »
Payers and providers can get templates for notices of privacy practices that must be furnished to plan members and patients from the Read more »Office for Civil Rights and Office of the National Coordinator for Health IT under the law. The enforcement deadline for the HIPAA Omnibus Rule is Sept. 23.
Touring the state Monday, Pennsylvania Governor Tom Corbett unveiled a new healthcare agenda with a proposal to expand Medicaid eligibility through private health plans, if the federal government is open to new cost-sharing and work requirements. Read more »
Seven radiation oncology providers in Pensacola, FL, are settling allegations of improper Medicaid, Medicare and TRICARE billing, and are set to pay a collective $3.5 million to the state and federal governments. Read more »
Wall Street is not expecting the type of robust enrollment in insurance exchanges that the Congressional Budget Office has predicted, but some investors are expecting federal policy changes that expose insurers to more risk. Read more »
The hospice community sees benefit in increased Medicare surveys of its facilities as an opportunity to improve their operations and to demonstrate to the public that they meet requirements.Currently, hospice surveys are many years apart. Read more »
It is becoming clearer that it will take time, strategy and investment for accountable care organizations to hit their anticipated mark. During the summer, the Centers for Medicare & Medicaid Services reported that all 32 Pioneer ACOs had improved quality of care for its participants, but only 13 were able to lower the cost of that care enough to share in the savings. Read more »
With profligate use of CT and Read more »scans widely blamed for increased healthcare spending, a new report shows that pairing automated prior authorization with evidence-based guidelines can ensure such tests are only used when necessary, improving patient safety while reducing medical costs by perhaps 40 percent.