Payer: Page 134
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Quality Payment Program needs more technical assistance, oversight, OIG finds
Without sufficient guidance, participating clinicians could struggle to succeed, while others may opt out of the program altogether, the report warns.
By Meg Bryant • Dec. 15, 2017 -
ACA enrollment expected to fall well short of last year
Democratic lawmakers have called on the White House to extend the Friday deadline to the end of January, which was the deadline in previous years.
By Les Masterson • Dec. 15, 2017 -
NEJM: Opioid crisis measures aimed at docs mostly fail
Policies such as making doctor shopping illegal, limiting the supply of opioids dispensed at one time and alerting high-prescribing physicians were found to have no meaningful effect.
By David Lim • Dec. 15, 2017 -
GHX debuts integrated cloud-based supply chain tool for healthcare
The tool, Clinical ConneXion, is currently available with Epic EHRs.
By Meg Bryant • Dec. 14, 2017 -
Analysis points to opportunities to reduce costly ICU stays
A Premier report identified 10 ICU diagnoses with the highest variation in length of stay.
By Meg Bryant • Dec. 14, 2017 -
Deep Dive
Latest MACRA, doctor fee rules could bring boost to telehealth, wearables
“This is a big step forward for Medicare’s ability to deal with chronic conditions," American Telemedicine Association's Gary Capistrant says of an unbundled payment code for remote patient monitoring.
By Meg Bryant • Dec. 14, 2017 -
Moody's: 5 conditions responsible for 30% of adverse health nationally
Individuals with healthy behaviors, higher education attainment and better economic outcomes are healthier, while health system factors have a relatively modest effect on the prevalence of physical health conditions.
By David Lim • Dec. 14, 2017 -
Providers warming to risk-based payments, survey shows
The AMGA report also found that multiple barriers remain for value-based contracting, including issues with data sharing, limited access to capital and a lack of commercial risk products.
By Les Masterson • Dec. 14, 2017 -
Aetna launches new policies to combat opioid crisis
The payer will waive copays for Narcan and limit opioids prescribed for acute pain and post-surgery.
By Les Masterson • Dec. 13, 2017 -
BCBS of Massachusetts paying members to shop around
The program will reward members $250 per procedure when they "shop for and get care from lower cost, quality providers."
By Les Masterson • Dec. 13, 2017 -
High-deductible plans don't reduce low-value healthcare spending, study says
The plans in their current form “may represent too blunt an instrument to specifically curtail" wasteful spending on services of lower value.
By Les Masterson • Dec. 12, 2017 -
HHS' OIG says undisclosed Medicare Advantage pilot passes regulatory muster
The pilot — which involves a hospital system, Medicare Advantage plan and trade association — would allow real-time access to patient discharge information.
By Les Masterson • Dec. 12, 2017 -
Collaboration, strategic investments and efficiencies on deck for 2018, PwC says
PwC's Health Research Institute upped the number of the top issues facing the industry after an eventful year filled with natural disasters and health policy uncertainty.
By Jeff Byers • Dec. 12, 2017 -
Optum's MedExpress and Walgreens team up on urgent care
The move reflects a growing trend toward vertical integration in healthcare.
By Meg Bryant • Dec. 8, 2017 -
MedPAC finalizes recommendation to repeal MIPS
The advisory group has gotten pushback for urging the repeal of MIPS, but many providers remain unprepared for MACRA payment changes and think the law is too complex.
By Shannon Muchmore • Dec. 8, 2017 -
More billing codes, demonstrations help bridge physician payment gap
CMS is incentivizing specific activities and pushing for favorable outcomes through its new billing codes and demonstrations, The Robert Wood Johnson Foundation said.
By Les Masterson • Dec. 8, 2017 -
Temporary physicians do not increase mortality risk, study says
A new JAMA Network report also found that patients treated by locum tenens physicians had higher Part B spending, longer length of stay and readmissions.
By Les Masterson • Dec. 7, 2017 -
US health spending growth slows, but still rises to 17.9% of GDP
Consumers still faced the fastest rate of growth in out-of-pocket spending since 2007, with an increase of 3.9%.
By David Lim • Dec. 6, 2017 -
AHA report offers advice about value-based payment programs
The AHA said a key to a hospital or health system's value-based payment program success involves an organization's "capabilities and culture" as well as market and policy forces.
By Les Masterson • Dec. 6, 2017 -
It's a myth the uninsured use the ER more often, study shows
Uninsured adults do use significantly less outpatient care than the insured.
By David Lim • Dec. 6, 2017 -
Getty / Edited by Healthcare Dive
UnitedHealth's Optum to buy DaVita clinics for $4.9B
DaVita Medical Group serves about 1.7 million patients per year through nearly 300 medical clinics featuring primary and specialist care.
By Jeff Byers • Dec. 6, 2017 -
Financial gap is growing between largest payers and the rest of the pack
A new Deloitte Center for Health Solutions found the three largest health insurers generated 84% of the total underwriting gains in 2016.
By Les Masterson • Dec. 6, 2017 -
Finding healthcare prices online no easy task, study finds
Just 17% of 1,346 websites included geographically relevant price estimates for one of four medical interventions.
By Meg Bryant • Dec. 5, 2017 -
One-third of practices didn't report performance data in value-based program
A study published in Health Affairs looked at the first year of Medicare's Physician Value-Based Payment Modifier program.
By Les Masterson • Dec. 5, 2017 -
Deep Dive
4 major questions about the proposed CVS-Aetna merger
The $69 billion merger announced Sunday is the kind of deal that can upend an industry.
By Shannon Muchmore • Dec. 5, 2017
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