FOCUS OF THE WEEK
$840M Plan Unveiled to Boost Transitions to Outcome-Based Healthcare
US Health and Human Services Secretary Sylvia M. Burwell announces new progams and financial incentives to help accountable care organizations (ACOs) and professional medical associations make the transition from fee-for-service to value-based healthcare delivery.
Unnamed Partner Helps Blues Give Managed Care Clients a Reprieve in New York State
More than 53,000 managed care clients in 6 western New York counties will not have to find a new insurer, thanks to an emerging partnership that caused the area’s BlueCross BlueShield carrier to reverse its decision to exit the health plans.
JAMA Article Outlines the Growing Pains of Pioneer ACOs
An article in the Journal of the American Medical Association outlines what both CMS and the Pioneer ACOs have learned in the early years of the program, such as the importance of engaging primary care physicians, not growing too quickly, and the need to find better ways to count which patients are in the ACO.
AJMC’s Dr Fendrick Elected to Institute of Medicine
The Institute of Medicine announced yesterday that A. Mark Fendrick, MD, co-editor-in-chief of The American Journal of Managed Care and a national leader in efforts to reform healthcare reimbursement strategies, is among 70 new members elected to the prestigious body.
How Do Today’s ACOs Differ From ’90s Managed Care?
As accountable care organizations, or ACOs, proliferate across the United States, a question arises for both veteran healthcare leaders and consumers: is the ACO something new, or just a relabeling of managed care vehicles created during the last wave of healthcare reform? A well-run ACO offers something better than the managed care of prior years, according to presenters at the gathering of the ACO and Emerging Healthcare Coalition, which took place October 16-17, 2014, in Miami, Florida.
Repeal or Replace: Healthcare on the Mind as Midterm Elections Approach
Despite continued Republican opposition to the Affordable Care Act, sentiment is shifting from repeal to replace. Still, the fact that open enrollment on HealthCare.gov begins after the midterm elections does not seem like a coincidence to the GOP.
Despite Being Satisfied with ACA Coverage, Consumers Are Expected to Shop Around During Open Enrollment
A majority of Americans covered by the Affordable Care Act are expecting to change plans for 2015, which may be a smart move, according to industry experts. People who simply re-enroll may not realize they are no longer among the lowest costing plans, which will affect how much their subsidies pay for.
Report of Second Texas Nurse With Ebola Fans Hospital Safety Fears
Health officials from CDC and the state of Texas are reeling in the wake of today’s report that a second nurse at the Texas hospital that treated Ebola patient Thomas Eric Duncan has tested positive for the virus. The news came while health leaders were still trying to determine how 26-year-old nurse Nina Pham contracted Ebola while caring for the first patient diagnosed with the disease on US soil. Meanwhile, the largest nurses' union says its members report that most hospitals are not ready for an Ebola patient.
Survey of Anticipated FY 2015 Medicaid Growth Finds More Expected in States that Approved Expansion
A survey by Kaiser Family Foundation projects 13.2% overall growth in Medicaid through fiscal year 2015, but the difference between states that expanded the program and those that did not will be stark. The survey of state Medicaid directors also finds 23 states plan expansion of managed care in the next year.
Transition to Managed Care Proves Rough for Ohio Dual Eligibles, Reports Say
Ohio is the latest state to experience a rough transition to managed care in its Medicaid program, according to weekend reports. Delayed payments and service disruptions to fragile patients are among the complaints. Kentucky had a similar bumpy start when it changed to Medicaid managed care in 2011, and Kansas has had many problems recently.