Laura Joszt, MA

Legal reforms that enact stronger protections against malpractice claims do not necessarily reduce defensive care, according to a new study by the RAND Corporation published in the New England Journal of Medicine.

The strict rules of the Meaningful Use (MU) program are preventing physicians from participating, according to the American Medical Association, which is calling for more flexibility and some relief from penalties.

Accountable Care Organizations participating in the Medicare Shared Savings Program will have access to a new initiative that will support care coordination across the country, according to CMS. Up to $114 million in upfront investments will be made available.

Quality in Medicare Advantage plans is increasing, and CMS credits the improvement to its star rating system. A growing number of Medicare enrollees are in plans receiving at least 4 out of 5 stars, according to a new fact sheet.

The quality bonus payments tied to CMS' star ratings makes it critical that health plans receive a 4 or better, Jonathan Harding, MD, chief medical officer of the Senior Products Division at Tufts Health Plan, said at the America's Health Insurance Plan's National Conferences on Medicare and Medicaid, and Dual Eligibles Summit in Washington, DC, from September 28 to October 2.

In states that chose not to expand Medicaid eligibility under the Affordable Care Act, residents with a median income of less than $800 a month are now ineligible for coverage assistance while those with more than $2000 a month are eligible for subsidies, according to a report from the Urban Institute.

Although many providers are looking to implement cloud, big data, social, and mobile technologies within the next 2 years, if they haven't done so already, few healthcare organizations feel their infrastructures are prepared for this evolution of electronic medical records, according to a new study.

Gilead Sciences' Harvoni represents the first once-a-day, complete treatment pill approved by the FDA to treat the hepatitis C virus (HCV). And for some patients, the drug will be less expensive than Gilead's other HCV treatment, Sovaldi.

Reference pricing programs can steer patients to lower-price, adequate quality providers, but potential savings to health plans and purchasers are actually modest, according to a study from the National Institute for Health Care Reform.

Despite progress being made, health information technology interoperability remains a struggle, according to a report submitted by the Office of the National Coordinator for Health Information Technology and HHS to Congress.

For the third year in a row, Medicare Part B monthly premiums and deductibles will remain unchanged at $104.90 and $147, respectively, according to HHS Secretary Sylvia Burwell.

There are 10 emerging healthcare trends that will impact managed care pharmacy organizations over the next 5 years as the United States healthcare system places more emphasis on affordability, population health, and patient satisfaction and quality of care, according to a new report from the Academy of Managed Care Pharmacy.

Financial results from the first 2 years of the Pioneer ACO Model reveals the gains and losses of the 32 organizations that started the program, and illuminates why just 19 remain.

The majority of low-income adults in 3 states favored Medicaid expansion, but knowledge about their states' plans for the program under the Affordable Care Act was low, according to a report from the Commonwealth Fund.

CMS released financial results from the first 2 years of the Pioneer ACO program. The program is down to 19 accountable care organizations from the original 32 that started the program, and the financial results reveal why those that dropped out did so.

Over the last decade, all 5 national coordinators for health information technology have discussed the importance of connecting healthcare data, but the timing is finally right now, according to Karen B. DeSalvo, MD.

Although people seem to assume Big Data will answer all questions and improve quality of care while increasing efficiencies, the healthcare industry needs to focus on what data is actually actionable, according to John Halamka, MD, chief information officer at Beth Israel Deaconess.

Including pharmacy benefits as part of an employer's total health insurance benefit package has clear health benefits and cost savings, according to a study from Blue Cross Blue Shield Association and Prime Therapeutics, LLC.

During the third year of the Hospital Readmission Reduction Program, CMS will penalize more hospitals than it did during the second and third years of the program; however, the overall readmission rate for Medicare beneficiaries is down.

The rising cost of prescription drugs, CMS initiative updates, and successes in home and community-based services for dual Medicare and Medicaid beneficiaries were discussed at the America's Health Insurance Plans' National Conferences on Medicare and Medicaid, and Dual Eligibles Summit in Washington, DC.

Hepatitis C and the price of Sovaldi were, understandably, the main focus of aconversation on rising prescription drug prices at the America's Health Insurance Plans' National Conferences on Medicare and Medicaid, and Dual Eligibles Summit in Washington, DC.

A new information governance framework of 8 principles from the American Health Information Management Association aims to help meet the patient care, safety, and operational goals of healthcare organizations.

At $531 billion, Medicaid is the second largest piece of healthcare spending and cannot be pushed off to be thought about another day, Cindy Mann, JD, CMS deputy administrator and director of the Center for Medicaid and CHIP Services, said at the America's Health Insurance Plans' National Conferences on Medicare and Medicaid and Dual Eligibles Summit.

The first round of Open Payments data, known as the Physician Payments Sunshine Act, were made public Tuesday and revealed 4.4 million payments valued at nearly $3.5 billion paid out to 546,000 individuals and almost 1346 teaching hospitals.

At the America's Health Insurance Plans' National Conference on Medicare and Medicaid and Dual Eligibles Summit in Washington, DC, Patrick Conway, deputy administrator for innovation and quality and chief medical officer for CMS, spoke on the future of delivery system reform.

Plans designed specifically for disabled dual-eligible Medicare and Medicaid beneficiaries are not necessarily enough to reduce use of costly services, according to a new report from the Government Accountability Office.

Medicaid enrollment under the Affordable Care Act grew even in states that chose not to expand eligibility, making access to care a more pressing issue, according to a new report issued by HHS' Office of the Inspector General.

Nearly $212 million in grant awards has been made available to all 50 states and the District of Columbia to support programs aimed at preventing chronic diseases, according to a recent announcement by HHS Secretary Sylvia M. Burwell.

UnitedHealthcare is establishing new accountable care organizations with Advocate Health Care and Illinois Health Partners that will provide coordinated care for more than 65,000 Illinois residents.

Healthcare providers have shown a lack of progress regarding ICD-10 readiness compared with a year ago, while vendors are mostly prepared, according to a new WEDI survey.