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Two hospitals, one in Georgia and another in California, charge in lawsuits that BCBS of Georgia sends payment directly to patients instead of paying the hospitals for care provided. The patients often do not know they are supposed to sign the checks over to cover the cost of their care, and the hospitals end up without payment.

This week, the top stories in managed care include the largest healthcare fraud takedown, one successful accountable care organization imparted its secrets, and a report identifies pharmacy trends in the public health exchanges.

The Oncology Care Model is one of the most recent bundled payment programs announced by CMS, going into effect July 1. Participants will need a robust data analytics program in order to meet practice requirements, and achieve clinical and financial goals. Read on for tips to achieve data-driven success, and a simulation of what practice data will look like under the model.

What we're reading, July 4, 2016: a hospital is offering free housing to get super-utilizers out of the emergency room; campaigns for patients to gain access to stem cell treatments are gaining momentum; and why hospital/physician integration and consolidation probably won't lower costs.

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