Insurance

Latest News


Preventive health services are key to ensuring people seek care before their conditions are critical or urgent in nature. As healthcare services for Medicaid and Medicare beneficiaries expand under the Affordable Care Act, so will the need for professionals who can administer certain preventive measures.

In an effort to offset cost increases associated with the Affordable Care Act (ACA), the Obama administration intends to expand hospitals' access of the 340B discount drug plan. While the expansion may sound promising to some, many others worry that the program will threaten the quality of care, as increased participation risks higher potential for abuse. Even worse, the 340B program will likely rise the cost of cancer care.

The Centers for Medicare & Medicaid Services Innovation Center held an Open Door Forum on Aug. 1 to announce some modifications to the application for the Comprehensive ESRD Initiative, or renal-specific Accountable Care Organization demonstration.

On July 8, 2012, the Centers for Medicare & Medicaid Services (CMS) released two major Medicare proposed rules impacting payment for physician and hospital outpatient services in 2014. ASH will submit comments to CMS on the proposed rules by the September 6 deadline and would like to incorporate feedback from the Society's practice-based members.

Physician groups voiced general support for a bill approved Tuesday by a Congressional subcommittee to replace Medicare's sustainable growth rate (SGR) formula.

This segment of the panel discussion takes a closer look at the episode of cost for a patient going to a hospital versus a private office setting. Panelists agree that the cost of hospital care is not that much greater than in the office.

Dr. Chernew asks the panelists how payers address the value of these costly combination therapies when there are less expensive options available. Dr. Newcomer says that the drugs being discussed are, in fact, having a significant clinical effect.

First year results are in - all 32 participants in the Pioneer Accountable Care Organization (ACO) initiative showed success in improving quality. However, not as much success was made in cost savings.

Pharmaceuticals companies continue to weigh options for their role in Accountable Care Organizations (ACOs).

Insurer UnitedHealth Group recently noted it will more than double payments made to physicians who participate in accountable care contacts. ACOs have already demonstrated an immense positive growth in quality care, and a reduction in medical costs.

New recommendations suggest reforming the federal 340b drug discount program. Originally designed to help providers serve the poor or underinsured, misuse has raised concerns for greater transparency in prices and how hospitals are using 340b savings.