Feed aggregator

Parkland Hospital Improving, but ED Deficiencies Persist

HealthLeadersMedia.com - Managed Care Contracting and Reimbursement Advisor - 6 hours 34 min ago

The Dallas safety net hospital is making "measureable progress" in implementing a corrective action plan to remedy deficiencies identified by the Centers for Medicare & Medicaid Services, a report shows. But some emergency department tasks are behind schedule.

Categories: Healthcare News

Medical Boards Step Up Disciplinary Actions

HealthLeadersMedia.com - Managed Care Contracting and Reimbursement Advisor - 7 hours 3 min ago

The Federation of State Medical Boards reports that the number of doctors punished by their states increased 6.8% between 2010 and 2011. But a citizen's advocacy group issues its own report, which suggests that states continue to fail to adequately protect the public from bad doctors.

Categories: Healthcare News

'Uninsurable' patients could lose coverage if the healthcare law is overturned

Healthcare News - 7 hours 14 min ago

Under President Obama's healthcare law, cancer patient Kathy Watson and nearly 62,000 other "uninsurable" patients are getting coverage through a little-known program for people who have been turned away by insurance companies because of pre-existing medical conditions, the Pre-Existing Condition Insurance Plan, known as PCIP. Watson's case illustrates the potential impact of tying everything in the far-reaching legislation to the fate of one provision, the unprecedented requirement that most Americans carry health insurance. State officials who administer the federal pre-existing condition plan in 27 states are trying to make fallback arrangements in case the law is invalidated and coverage suddenly terminates.

Categories: Healthcare News

Banner Health, Aetna reach for ACO gold

Healthcare News - 7 hours 22 min ago

Aetna recently announced an agreement with Banner Health Network (BHN) to provide technology that will support a health information exchange, improve patient data analytics, and add mobile connectivity. The May 10 announcement comes as the Banner Health Network, a Phoenix, Ariz.-based health system, transitions into an accountable care organization (ACO) through the Pioneer Accountable Care Organization initiative. To advance its ACO goals, Banner will adopt technology and services from Medicity, ActiveHealth, and iTriage--all Aetna subsidiaries. The technology will support services offered to the 50,000 Medicare fee-for-service patients covered under the Pioneer ACO shared savings program as well as to the members in Aetna's ACO relationship with Banner Health Network.

Categories: Healthcare News

D.C. Archdiocese, Georgetown spar over Sebelius speech

Healthcare News - 7 hours 27 min ago

Tensions between the Archdiocese of Washington and Georgetown University are escalating ahead of an address on Friday (May 18) by Health and Human Services Secretary Kathleen Sebelius. Sebelius, a Catholic whose support for abortion rights and President Obama's contraception insurance mandate has infuriated bishops and conservative Catholics, was chosen last fall by students at Georgetown's Public Policy Institute to deliver a speech at the school's annual awards ceremony on commencement weekend. The Cardinal Newman Society, a conservative watchdog group, called the Sebelius invitation "outrageous," and on Wednesday (May 16) sent an online petition with 26,000 signatures to Georgetown President John DeGioia, warning him that he had "two more days to stop this scandal and insult."

Categories: Healthcare News

Physicians receive federal innovation grants

American Medical News - Gov't - Thu, 05/17/2012 - 08:06

With support from the health system reform law, 26 projects aim to reduce health spending through decreased utilization and improved primary care access.

Categories: AMA

HHS Exchange Funding Tops $1B

Healthcare News - Thu, 05/17/2012 - 07:04

The Department of Health and Human Services has announced $181 million in new grants to help states establish health insurance exchanges. HHS also issued two guidance documents to help states build exchanges.

Categories: Healthcare News

HHS Exchange Funding Tops $1B

HealthLeadersMedia.com - Managed Care Contracting and Reimbursement Advisor - Thu, 05/17/2012 - 07:04

The Department of Health and Human Services has announced $181 million in new grants to help states establish health insurance exchanges. HHS also issued two guidance documents to help states build exchanges.

Categories: Healthcare News

OIG Uncovers Flaws in CMS Processes, Programs

Healthcare News - Thu, 05/17/2012 - 06:49

A recent spate of Office of Inspector General audit reports calls into question some programs from the Centers for Medicare & Medicaid Services. For example, a review of the Medicare fee-for-service error rate finds that the calculation methodology is flawed.

Categories: Healthcare News

OIG Uncovers Flaws in CMS Processes, Programs

HealthLeadersMedia.com - Managed Care Contracting and Reimbursement Advisor - Thu, 05/17/2012 - 06:49

A recent spate of Office of Inspector General audit reports calls into question some programs from the Centers for Medicare & Medicaid Services. For example, a review of the Medicare fee-for-service error rate finds that the calculation methodology is flawed.

Categories: Healthcare News

Insurers to lose $1 trillion if health law struck down

Healthcare News - Thu, 05/17/2012 - 06:36

Nearly one-tenth of the insurance industry's total revenue through 2020 is at stake in the Supreme Court's decision on healthcare reform, a new study by Bloomberg Government says. That figure equals about $1 trillion, or about one-half percent of the projected U.S. gross domestic product over eight years, the report said. The $1 trillion in new revenue would come from the law's expansion of Medicaid and from subsidies to individuals purchasing insurance. Though most of the money would eventually flow to healthcare providers, insurers would keep an average of $22 billion per year for profit and administrative costs, the study said.

Categories: Healthcare News

Taxes lurk behind court test of Obama health law

Healthcare News - Thu, 05/17/2012 - 06:33

While Supreme Court watchers focus on the controversial insurance requirement in President Barack Obama's healthcare law, lesser known is that the court's ruling next month will also decide the fate of billions of dollars in new taxes. The 2010 law includes a 3.8-percent boost in taxes on investment income and a 0.9-percent increase in the Medicare payroll tax, both hitting people who earn more than $200,000 a year. Set to take effect in 2013, the two increases have been called into question by the court case, which also has clouded the outlook for new provisions already in effect, such as a small business tax credit and a tax on tanning salons.

Categories: Healthcare News

Immigration status a health policy challenge

Healthcare News - Thu, 05/17/2012 - 06:29

The national health law explicitly excludes illegal immigrants—a politically explosive topic—and bans them from the new state insurance exchanges, even if they use their own money. They will make up a big chunk of the remaining uninsured population. But advocates say states have good reasons to reach out and get uninsured legal residents covered—especially as the federal government picks up most of the tab.

Categories: Healthcare News

Opinion: When competitive bidding hurts patients

Healthcare News - Thu, 05/17/2012 - 06:16

Because of Medicare's size and position in the healthcare market, it is likely that this policy will be quickly adopted by Medicaid and private insurers. A one-year experiment with expanded competitive bidding that was recently conducted by Medicare yielded cost savings of 42 percent, without reducing the quality of care, and was hailed as a great success. But if competitive bidding is predicated on supplying equipment at the lowest possible price, something has to give. And more likely than not, that something will be patient care.

Categories: Healthcare News