Health Care Delivery

Acting Administrator Andy Slavitt says the Fraud Prevention System has yielded a 10-to-1 return for taxpayers

An interview with The American Journal of Managed Care about the PAN Challenge grant.

While new care delivery models have provided better support for patients, there are still many patients who still face challenges with the complexity of treatment, explained Daniel J. Klein, president and chief executive officer of the Patient Access Network (PAN) Foundation.

The newly insured came to Medicaid with medical issues that had gone unaddressed for years. The same problem has been cited by insurers who have asked for large rate increases for 2016 for plans on the exchanges.

The 17th annual HealthCare's Most Wire Survey indicates that hospitals are beginning to utilize information technology to send and share information across care settings.

CDC report estimates that the Affordable Care Act could lead to 111,000 fewer new coronary heart disease events and 95,000 fewer CVD-related deaths by 2050.

President Barack Obama has nominated Andy Slavitt to become the new administrator of CMS.

Cigna and Providence-Swedish Health Alliance ACO in Western Washington recently launched a care collaboration initiative that will benefit more than 7100 individuals who are covered by a Cigna health plan.

New exchange plan enrollees during the first quarter of 2015 spent less on medications than new enrollees during the same time frame 1 year ago

Newly insured consumers under the Affordable Care Act have turned out to be sicker than initially estimated, according to health insurance companies, who are seeking rate increases of at least 20% to 40%, reported the New York Times.

Although nearly equal amounts of people view the Affordable Care Act favorably (43%) as unfavorably (40%), a majority of Americans say they approved of the Supreme Court's decision to continue to allow Americans living in states on the federally facilitated exchange to be eligible for insurance subsidies, according to a recent poll by the Kaiser Family Foundation.

This week GOP presidential candidate hopefuls turned their attention to the 2016 election as the next best chance to repeal Obamacare, and CMS released data revealing $6.5 billion payments to healthcare providers from drug and medical device makers in 2014.

The deal combines Humana's 3.2 million Medicare enrollees with Aetna's 1.26 million Medicare enrollees, giving the new combined company a strong position as the baby boomer population ages.

In addition to increasing insurance coverage, the Affordable Care Act also aims to improve population health and lower healthcare costs. However, not much attention has been paid to the quality of care the newly insured are receiving.

The health coverage of millions of Americans in 34 states was pending upon the Supreme Court decision on the King v Burwell case. Luckily, common sense prevailed and the Supreme Court based its ruling on the original motivation behind the creation of the exchanges rather than on the plain language used in the provision.

CMS has begun to implement risk adjustment and reinsurance programs, 2 premium stabilization programs of the Affordable Care Act. The report highlighted the estimated reinsurance payments issuer in addition to summary level information on the programs, which helps to keep premiums affordable as well as various coverage options available to consumers.

Despite concerns that Medicare Advantage payment reductions included in the Affordable Care Act would lead to a decline in enrollment, the number and share of beneficiaries enrolling in Medicare Advantage has only continue to climb since the health reform law was enacted.

In an effort to better examine and understand the implementation and effects of the Affordable Care Act, researchers from the Urban Institute found that nongroup health insurance premiums in insurance marketplaces were lower than expected.

Police officers in the United States are woefully untrained to approach individuals with behavioral health issues, according to a new analysis from Washington Post. In the first 6 months of 2015, police have shot and killed 123 people in the throes of mental or emotional crisis.

Although GOP presidential hopefuls are all campaigning on promises to repeal and replace President Obama's Affordable Care Act (ACA), the last real chance to repeal may have been the 2012 election, according to Avik Roy, senior fellow at the Manhattan Institute.

Shortly after the Supreme Court ruled in favor of the government in King v. Burwell, President Barack Obama triumphantly claimed that "Affordable Care Act is here to stay." However, the truth is that GOP presidential hopefuls have no intention of letting the law stand.

This week the Supreme Court ruled in favor of the government in King v. Burwell, preserving access to healthcare subsidies for millions of Americans, and the high cost of cancer drug was in the spotlight.

The King v. Burwell decision to uphold subsidies on the federal marketplace is a win for patients who might have lost their mental health insurance coverage.

With the Supreme Court ruling in King v. Burwell keeping subsidies available to consumers on the federally facilitated marketplace, healthcare associations, insurers, health plans, and other stakeholders have been voicing their support and relief at the 6-3 ruling.

Although Kentucky and Arkansas went about expanding Medicaid coverage in 2 different ways, they shared common strategies that led to their success.

More than half of physicians in a nationwide survey are willing to see their patients over video, claiming the work-life balance to be the most common reason for the potential change in health system referrals.

The Core Quality Measures Collaborative Workgroup, initiated by AHIP and payer organizations, seeks to reduce, refine, and relate the healthcare delivery process.

The Supreme Court may have kept subsidies available to all Americans regardless of whether their state has set up its own exchange, but some people still refuse to purchase coverage, and they're perfectly happy remaining uninsured.

In a triumphant win for President Obama's Affordable Care Act and millions of Americans, the Supreme Court of the United States ruled against the plaintiffs in the case King v. Burwell and upheld the availability of subsidies for individuals on the federally facilitated marketplace.

A new study summarizing network size by physician, not just hospital participation, determined that 41% of networks on the marketplaces can be considered small or x-small and contain just 25% or less of office-based physicians in the area.