Health Management

The Affordable Care Act has ushered in a new era of convergence among healthcare payers and providers.

More than half of all Medicaid beneficiaries nationwide were enrolled in a managed care organization as of September 2014, according to a new analysis by the Kaiser Family Fund.

Hospitals with high rates of certain hospital-acquired conditions (HACs) will have their Medicare payments cut by 1% for the 2015 fiscal year.

Providers and care teams working to improve the health of overweight and obese patients must keep hypertension detection and management top of mind for this population.

Providers, owners and suppliers who owe Medicare money, have been convicted of felonies or have a history of billing abuse will be excluded from enrollment under new rules adopted by the Centers for Medicare and Medicaid Services (CMS).

Researchers generally agree that intense, highly-coordinated care, with an emphasis on changing patient behavior is a key to improving outcomes and reducing costs for complex morbidities.

The industry is challenged by a number of issues in 2015 including cost control, technology threats, and the emerging consumer market.

An estimated 50,000 fewer patients died in hospitals and approximately $12 billion was saved between 2010 and 2013 because of reduced hospital-acquired conditions,according to the U.S. Department of Health and Human Services (HHS).

Total national health spending slowed from 4.1% in 2012 to 3.6% in 2013, the slowest rate of growth since it was first tracked in 1960, according to a report from the Office of the Actuary (OACT) at the Centers for Medicare and Medicaid Services (CMS).

Thomas Malone, MD will become chief executive officer at Summa Health, and Karen Rohan will become president of Aetna, as of January 1, 2015.

Considering the challenges they faced during the first open enrollment period, Consumer Operated and Oriented Plans (CO-OPs) overall are doing very well, having signed up some 450,000 members across the nation, or 18% of all ACA exchange plan enrollees to date.

Americans in 2013 spent a little more on medical services from the prior year, but utilized them less, according to a new report by the Health Care Cost Institute (HCCI).

Healthcare organizations can implement operational changes to control spiraling healthcare costs, which will account for nearly 20% of the country's GDP by 2021.

A new Kaiser health tracking poll shows 90% of uninsured Americans are not aware of the Affordable Care Act’s (ACA’s) next open enrollment period.

Public-private partnerships are proving to be an effective structure for funding and governing patient registries.

America’s health care system is going through transformational changes. Price transparency – providing consumers cost information before services are received – is a significant force in today’s system.

Patients who saw a physician assistant (PA) in the past year give high marks to the interaction, according to a new Harris Poll.

The average cancer survivor with insurance incurs $712 in monthly bills for physician copayments, prescription drugs and other expenses related to treatment, according to a new study from Washington National’s Institute for Wellness Solutions.

Employers are attempting to mitigate rising costs resulting from the ACA by shifting them to employees, according to a new survey from the Darla Moore School of Business at the University of South Carolina.

All-encompassing change to the U.S.’s end-of-life care system is urgently needed.

Market readies for explosion of new technology, drugs

Better care coordination is needed

One in five elderly patients are readmitted to the hospital within 30 days of leaving, according to government data.

Approaches include the enlistment of care coordination programs and overhauling existing chronic care models

Focusing attention on these individuals can bring both short-term and long-term clinical and economic benefits