Without Medicaid,Hospitals May Pay Patient Premiums
July 25th 2014Uncompensated care was supposed to be a thing of the past, but it's persisting in many states not expanding Medicaid eligibility. As an alternative, for some high-cost uninsured patients, hospitals are turning to a new option.
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Dual-Eligibles Not Opting Into State Care Coordination Programs
July 24th 2014To better align the care of beneficiaries insured under both the Medicaid and Medicare programs, CMS invited states to participate in a 3-year demonstration project. However, it seems that many beneficiaries have opted out of these care coordination programs that are offered across the country.
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To Prevent Surprise Bills, New Health Law Rules Could Widen Insurer Networks
July 21st 2014The Obama administration and state insurance regulators are developing stricter standards to address the concerns of consumers who say that many health plans under the Affordable Care Act have unduly limited their choices of doctors and hospitals, leaving them with unexpected medical bills.
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CMS Announces Changes to Medicare Hospice Drug Rule
July 21st 2014Changes to a hospice drug rule will reduce the types of medications that require prior authorization. Previous rules prohibited Medicare hospice patients from filling their Part D medications until they had confirmed that hospice providers did not cover them first.
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Lawmakers Urge CMS to Extend MU Hardship Exception for Pathologists
July 18th 2014Eighty-nine members of Congress have asked the Centers for Medicare & Medicaid Services to give pathologists a break and extend the hardship exemption they currently enjoy for all of Stage 3 of the Meaningful Use program.
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Why Are Payers Concerned with Patient Engagement Strategies?
July 18th 2014While healthcare organizations and providers are addressing strategies for engaging patient populations in the pursuit of incentive or value-based reimbursements, payers are actively looking for ways to engage this same population as consumers in the name of healthcare reform.
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Personalized Medicine: It May be High Cost, but It's Higher Value
July 18th 2014Personalized medicine will be expensive in these early days of pioneering and planning. But individual genomic testing is not going to be exorbitant forever — and the ROI is gonna be big, both in patient outcomes and dollars saved.
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Value-Based Care: Thinking Beyond Financial Incentives
July 18th 2014When it comes to value-based decision making, several factors can influence physician behavior. Although many organizations rely on financial incentives, the Commonwealth Fund argued in a report released Tuesday that healthcare leaders should think beyond the dollars and dimes.
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