Insurance

Uncompensated care was supposed to be a thing of the past, but it's persisting in many states not expanding Medicaid eligibility. As an alternative, for some high-cost uninsured patients, hospitals are turning to a new option.

To better align the care of beneficiaries insured under both the Medicaid and Medicare programs, CMS invited states to participate in a 3-year demonstration project. However, it seems that many beneficiaries have opted out of these care coordination programs that are offered across the country.

Dr Benner presented a program that helps providers improve medication adherence among their patients.

Medicare-Advantage Prescription drug plans (MA-PDs) and standalone PDPs appear to respond to different incentives for plan design.

Changes to a hospice drug rule will reduce the types of medications that require prior authorization. Previous rules prohibited Medicare hospice patients from filling their Part D medications until they had confirmed that hospice providers did not cover them first.

Eighty-nine members of Congress have asked the Centers for Medicare & Medicaid Services to give pathologists a break and extend the hardship exemption they currently enjoy for all of Stage 3 of the Meaningful Use program.

Health insurers are increasingly turning to telehealth, a transition that will change the way that providers assess and treat patients.

Fewer patients linger for days in hospitals without being admitted because of a new federal rule, but hospital and consumer groups are suing the government because they say the policy compromises Medicare patients' care, and patients are often stuck with costly, unexpected bills.

Wellness and behavioral health visits are among a few telehealth coverage expansions the CMS wants to add to the list of Medicare-reimbursable telehealth activities under a proposal released Thursday.

Despite increased spending, the breast cancer detection rate and stage did not change, according to a new JNCI study.

The number of healthcare organizations participating in CMS's bundled payment program is expected to increase in upcoming weeks.

Most 30-day readmissions are experienced by patients who have multiple hospital stays. Efforts to reduce readmissions must look beyond a single 30-day period.

CMS stated that they seek recommendations about how the ACO program might evolve to "encourage greater care integration and financial accountability."

The American Journal of Managed Care followed up the first meeting of its ACO and Emerging Healthcare Delivery Coalition with its first interactive conference call, which was open to all members. Anthony Slonim, MD, DrPH, a Coalition co-chair who on July 1 will become president and CEO at Renown Health in Reno, Nev., moderated the roundtable discussion.

Two studies presented at the American Diabetes Association's 74th Scientific Sessions show that evaluating diabetes risk and patient health by nation of origin and ethnic background yields richer insights into how the disease affects populations.​

The drug industry scored a victory last month against the Obama administration's plans to give hospitals millions of dollars in discounts through the 340B program on orphan drugs. But HHS is sticking to its position that the Patient Protection and Affordable Care Act promises breaks on the expensive drugs when they're used for non-orphan indications.

Some 59 percent have received meaningful use Stage 1 incentives.

An analysis examining Medicare data found that the number of elderly beneficiaries receiving narcotic painkillers and anti-anxiety medications drastically increased from 2007 to 2012.

The CMS' release of per capita spending for Medicare beneficiaries shows that some states, particularly in the South, Midwest and Mid-Atlantic, are spending significantly more on inpatient and post-acute care than northern and western states.

Dr Chernew asks panelists about the role of insurers and Medicare for patients in the treatment of multiple myeloma. While insurers may not have necessarily been a barrier to care, costs of drugs have been.

Charges for some of the most common inpatient procedures surged at hospitals across the country in 2012 from a year earlier, some at more than four times the national rate of inflation, according to data released by Medicare officials on Monday.

A new study finds that Medicare is spending billions of dollars more than it needs to on prescription drugs for low-income seniors and disabled beneficiaries.

With 36 states utilizing Healthcare.gov, and with at least 2 additional states considering enrollment, the concept of a national healthcare insurance exchange (HIE) may quickly become a reality.

In the search for meaningful patient care improvements and sustainable financing, some independent physician groups are charting unique approaches that may offer models for payers and providers in the age of cost-containment and risk-sharing.