There seems to be a growing consensus among healthcare stakeholders that despite new reforms, something still has to give in the way care is delivered. Episode-based payment may be a viable solution. It is an intermediate step between fee-for-service, which historically leads to overuse or underuse of services depending on reimbursement, and capitalization, which moves all the risk to the provider.
Comparative effectiveness research is suddenly flush with fundings. Tucked in last year's American Recovery and Reinvestment Act was $1.1 billion to accelerate CER.
People over the age of 80 is the fastest-growing population sement in the United States, and they are also the most susceptible to falling through the cracks in the healthcare system.
Medicaid rolls will be expanded to include those earning up to 133% of the federal poverty level and adults without children.
It is possible for hospitals to provide high value to Medicare and commercial payers.
With more people gaining access to affordable coverage and an increasing elderly population, America will need more general internists and other primary care doctors than the primary care physician supply, according to the American College of Physicians (ACP).
In a move toward accountable care, the Blue Cross and Blue Shield Assn. (BCBSA) has established a policy that denies acute care hospitals reimbursement for certain never events.
Physician assistants (PAs) and nurse practitioners (NPs) could solve the shortage of primary care physicians and the rising cost of healthcare.
In the alphabet soup of healthcare, nothing's garnering greater attention these days than accountable care organizations.
Insurers are no longer shy about letting members comment on care experiences
Coordination of care helps decrease costs and ensures effect use of resources
Compared to other countries, U.S. patients are more likely to forgo care because of cost
If more patients are covered by Medicaid, hospitals stand to become unstable under reimbursement of 88 cents on the dollar
Reducing water and electricity use can produce immediate savings for hospitals while recycling efforts pay off in the longrun
Online virtual lifestyle management must include evidence based programs that are flexible and integrated
One case of a mother and child shows promise in family-oriented weight management and risk reduction
A systematic evaluation is needed to evaluate eICUs effect on quality and costs.
State performance scorecard tracks uninsured kids, access, quality and costs. Often lack of data stalls quality incentives in pediatrics
The University of Miami and technology partners Microsoft and Resolute Solutions Corp. are teaming up to see if patients with diabetes can self manage their disease virtually while replicating the traditional patient-provider relationship.
Bayonne Hospital Center-Horizon Blue Cross Blue Shield of New Jersey heats up.
Proactive organizations will begin a painful transition to emerge as larger, fuller enterprises with concentrated authority designed around very different roles and responsibilities than what they have today
Standardized medical policies, appropriate technology, centralized authorization tools can render a decision before the patient leaves the clinic
If you help patients and members address challenges in their basic life needs, they will better attend to their healthcare and avoid costly events
Providers would like access to patient data beyond their own EMRs from retail clinics.
Analysts speculate Health Net will sell off businesses in key states where it's not the market leader.
