Insurance

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.

Veterans Affairs Secretary Eric Shinseki has resigned amid widespread troubles in the VA healthcare system. President Barack Obama says he accepted the resignation with "considerable regret."

Medicare overpaid physicians $6.7 billion in 2010 for evaluation and management services, HHS' Office of Inspector General said in a study released Thursday.

There are rumblings that federal lawmakers may be willing to repeal Medicare's burdensome rule requiring physicians in critical access hospitals to make an educated guess that the patients they're admitting will be either discharged or transferred in less than four days.

Advocates for a single-payer Medicare for all health system are fanning out across Capitol Hill this week, lobbying members of Congress.

The patient-centered medical home model in Arkansas, which has more than 600 participating providers, helps the state's Medicaid program incentivize quality care instead of paying for volume of services.

A new study estimates that it would cost Medicare about $2 billion a year to screen certain current and former heavy smokers for lung cancer.

A CMS ruling would force healthcare providers to enroll in Medicare by June 1, 2015, if they plan to prescribe medications that are paid for by the program. The agency said in a report that changes to Medicare Part D were necessary in order to cut down on inappropriate prescription practices and to improve patient safety.

Analysis of the impact of individual features of the patient-centered medical home care model on future healthcare expenditures among Medicare beneficiaries.

Every person covered by Medicare would shell out an additional $3 a month if the government agreed to pay to screen certain current and former smokers for lung cancer, a new study estimates.

Avik Roy, senior fellow, Manhattan Institute, says that the problem with the community rating provision is that age bands can make insurance costly for young patients.

Emerging health models all focus on 2 things in transforming care delivery: quality and cost-effectiveness. In order to achieve those standards, providers must adopt practices which support value, and cut those services or procedures that don't.

One in four Medicare patients got medical care at least once in 2009 that provided no benefit at a total cost of at least $1.9 billion, newly published research suggests.