Insurance

Big data, electronic health records, online health insurance portals-countless technology innovations are emerging, but how important are they for health leaders to adopt? According to analysts at Forrester Research, a global research and advisory firm, it's not only extremely imperative, but a matter of organizational survival.

The Senate approved a bill Monday evening that prevents steep cuts to Medicare physician payments from going into effect for one year and delays the conversion to ICD-10 diagnostic and procedure codes for at least one year.

The Medicare Payment Advisory Commission (MedPAC) recently aired concerns as to whether the patient-centered medical home (PCMH) can serve as a model for providing value-based care. In particular, several members asserted that the medical home model may have a real cost disadvantage for health systems. They explained that without evidence-based research, it is difficult to determine if the model encourages practices to use their cost savings to improve care.

Doctors are trying to stoke a rebellion against the doc fix.

The House of Representatives passed a controversial bill that will extend the sustainable growth rate (SGR) formula for physician payments for 1 year.

The Centers for Medicare & Medicaid Services' proposal to mandate broader provider networks in public insurance exchanges could have the unintended consequence of discouraging insurer participation, according to analysts at Moody's.

Despite opposition from doctors' groups, on a voice vote Thursday, the House of Representatives passed a one-year patch for Medicare's unpopular sustainable growth-rate formula for physician payments and, in the same bill, extended the implementation deadline for ICD-10 diagnostic and procedural codes for at least a year.

Facing heavy bipartisan opposition on Capitol Hill as well as from patient groups, businesses, insurers and others, the Centers for Medicare & Medicaid Services said Monday it did not plan to move ahead at this time with several proposed changes to the Medicare prescription drug program.

The House Ways and Means bill to temporarily prevent Medicare physician payment cuts also would deliver an Easter gift to hospitals-a six-month extension to comply with a controversial new inpatient payment rule for hospitals.

Another temporary 12-month patch will be enacted for the doc fix prior to the scheduled March 31 expiration of the current patch, House Speaker John Boehner (R-Ohio) indicated Wednesday.

New rules for Medicare Advantage (MA) plans would protect elderly citizens who might otherwise lose access to their preferred network of doctors.

The prospects for a permanent doc fix prior to the March 31 deadline are looking increasingly remote.

Gary Liska, with Alere Home Monitoring Inc, says Alere's commitment to patients' safety is why they supported the STABLE study.

The American Journal of Accountable Care will be the media sponsor for a seminar set for March 27-28, 2014, at Innisbrook Golf and Spa Resort in Palm Harbor, Fla., sponsored by TripleAim ACO Consulting Group. TripleAim's mission for the event is to share how the 29 ACOs that experienced shared savings of $126 million in 2012 accomplished the task, and to guide newer ACOs to success.

As Congress tries to reform Medicare, the program's independent advisor has its own suggestions, including a call to end to what has become a revenue buffer for many hospitals and an integral part of their physician acquisition strategies.

This study examines disparities in important patient-reported functional outcomes not routinely assessed among diverse racial/ethnic groups in Medicare managed care.

After the disastrous rollout of the healthcare exchanges last October, Kathleen Sebelius has hit the road to pump up enrollment-and it just might be working.

Medicare doctors are accustomed to wearing the white coats and diagnosing others' problems. But in coming months they may feel more like they're the ones wearing backless hospital gowns, as the federal government reveals previously undisclosed information about doctors' finances and performance.

The Sustainable Growth Formula (SGR) Repeal and Medicare Provider Payment Modernization Act has been framed as a bipartisan solution to establishing a permanent doc fix. The only problem, it seems, is how Congress will pay for the SGR's elimination.

The White House has decided to reverse roughly $10 billion in cuts to the cost-sharing subsidies that were part of the Patient Protection and Affordable Care Act. That program was originally expected to be slashed by 7.3 % in fiscal 2015 and beyond as part of the sequester cuts.

Under pressure from the industry and Congress, the Centers for Medicare & Medicaid Services is withdrawing several proposed changes to the Medicare drug program, but still charging ahead with others that could prove disruptive.

Prescription records show that as use of opioids like OxyContin and Vicodin soared in the 2000s, so did the use of "benzos" such as Xanax, Klonopin, and Ativan, as opioid users discovered tranquilizers could enhance "the high."

Accountable care organizations (ACOs) and other population health initiatives cannot succeed without health information being able to flow between healthcare organizations and providers.

A Centers for Medicare & Medicaid Services (CMS) proposal would remove a number of prescription drug classes from Medicare Part D drug plans, while also limiting the number of plans insurers could offer to seniors.

he lower chamber is expected to vote on legislation that would permanently repeal Medicare's sustainable growth-rate formula for physician payment, which might also include a provision to either repeal or delay the ACA's individual insurance mandate as a way to pay for the SGR fix.

Sen. Ron Wyden (D-Ore.), in his first speech as the new chairman of the powerful Senate Finance Committee, said it's important for Congress to pass legislation that would permanently repeal Medicare's contentious physician payment formula, but did not say how lawmakers intend to pay for it.

Open enrollment for the 2014 state and federal health insurance exchanges will end this month, but various findings contest their anticipated success.