Minnesota Becomes Fourth State to Lose Chief of Exchange
The director of Minnesota’s health insurance exchange, April Todd-Malmlov, abruptly resigned this week, making the exchange the fourth state program to see a leadership change in the midst of mounting criticism over the rollout of President Obama’s new health care law.
HTN Guidelines Loosen BP Cutoffs
The long-awaited update to guidelines for the management of hypertension - from the panel appointed to the Eighth Joint National Committee (JNC 8) - raises the recommended blood pressure threshold to determine the need for drug therapy in many patients.
Healthcare’s New Bottom Line: Experts Weigh In On Moving ACOs From Theory To Practice
Moving healthcare reimbursement from fee-for-service to a system that rewards quality care is easier said than done, but tools are emerging to help the cause. Three expert commentators featured in the inaugural issue of The American Journal of Accountable Care examined the challenges providers face, as they are being ask to share risk under new contracts with accountable care organizations, or ACOs.
Florida Healthcare Collaborative Offers Road Map For Creating Partnerships to Contain Costs
PLAINSBORO, N.J. From leveraging their joint buying power to better deployment of a hard-to-find pediatric liver transplant surgeon, two large healthcare systems in Florida are seeing the benefits of sharing resources on a bigger scale, according to Kavita Patel, MD, of the Brookings Institution, and her co-authors who write in the inaugural issue of The American Journal of Accountable Care.
Reforming Medicare’s Physician Payment Strategy
Since 1992 Medicare has reimbursed physicians on a fee-for-service basis. In 1997, as medical costs escalated, Congress began using a Sustainable Growth Rate (SGR) formula to reduce reimbursements if overall physician spending exceeded the growth in the economy.
Big Data Solves Healthcare Obstacles
When you are waiting for results from a medical test like a cancer biopsy, that call from your doctor can’t come fast enough. As a doctor, I am sometimes so buried in an avalanche of medical records that it can delay decisions about what to do next.
Your Forum for Tracking the Changing Healthcare Landscape: The American Journal of Accountable Care
The publisher of The American Journal of Managed Care is proud to introduce a new publication devoted to covering the nation's transition from fee-for-service to payment for quality: The American Journal of Accountable Care, reaching more than 40,000 healthcare professionals four times a year, is a stakeholder-driven publication from the publisher that has brought you the best peer-reviewed research on managed care over the past 20 years.
Marketplace Plans’ Networks Are Very Small, Study Finds
To keep premium prices down for individuals and small businesses buying coverage through new online marketplaces, insurers have created smaller networks of hospitals. But consumers and policy experts have wondered, just how small?
U.S. Healthcare System Ranks 22nd in Healthcare Spending
A new study by researchers at the UCLA Fielding School of Public Health and McGill University in Montreal reveals that the United States health care system ranks 22nd out of 27 high-income nations when analyzed for its efficiency of turning dollars spent into extending lives.
3-Month 'SGR Fix' Passes House
The House of Representatives passed a 3-month patch late Thursday to stabilize physicians' Medicare payments -- delaying dramatic cuts scheduled for 2014 -- while Congress works on a permanent repeal of Medicare's sustainable growth rate (SGR) payment formula.
Budget Deal Could Overhaul Medicare Long-term Acute-care Pay
The bipartisan budget deal reached this week could drag out efforts to overhaul Medicare's payment formula for physicians as lawmakers pursue a short-term fix and attempt to extend and make other tweaks to Medicare provisions, including significant changes to reimbursement for long-term acute care.
Work Continues on SGR Repeal
Congress' work to reshape physician payments under Medicare and repeal the sustainable growth rate (SGR) payment formula took several pivotal steps this week.
HealthCare.gov Enrollment Topped 100,000 in November, HHS Says
More than 100,000 individuals selected a private insurance plan through the federal online marketplace in November, HHS announced Wednesday. That's roughly four times the enrollment total during October, when the HealthCare.gov website was largely dysfunctional. But it was far short of the levels needed to meet the Obama administration's projection of 3.3 million enrollees by Dec. 31.
Federal Exchange Sends Unqualified People to Medicaid
The federal health care exchange is incorrectly determining that some people are eligible for Medicaid when they clearly are not, leaving them with little chance to get the subsidized insurance they are entitled to as the Dec. 23 deadline for enrollment approaches.
Transparency is Key to Free-Market Cost Control
Competition over healthcare prices and quality is coming. Transparency and the radical redesign of health insurance benefits will be its handmaiden. Companies such as General Electric are leading the way.