Community Partners to Assist Medicaid Beneficiaries
Preventive health services are key to ensuring people seek care before their conditions are critical or urgent in nature. As healthcare services for Medicaid and Medicare beneficiaries expand under the Affordable Care Act, so will the need for professionals who can administer certain preventive measures.
Health Reform Will Cost Cancer Patients
In an effort to offset cost increases associated with the Affordable Care Act (ACA), the Obama administration intends to expand hospitals' access of the 340B discount drug plan. While the expansion may sound promising to some, many others worry that the program will threaten the quality of care, as increased participation risks higher potential for abuse. Even worse, the 340B program will likely rise the cost of cancer care.
Study: Option Pricing Optimal in Cost-Effective, Collaborative Care
Findings published this month in The American Journal of Managed Care suggest that a more cost-effective solution may be possible through option pricing. This call options tool may resolve many payers' concerns about entering shared saving contracts with providers.
ACA Implementation Continues to Face Challenges
Delaying the employer insurance mandate until 2015 has cost the government an estimated $12 billion in fees. This coming after an assessment conducted by The Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) on the impact the delay will have on the Affordable Care Act (ACA) implementation.
ACA Mandates Questioned by Congress and States Alike
At the heart of Washington, government workers are concerned about what healthcare reform will mean for them. A mandate in the Affordable Care Act (ACA) will require Congress members and their aids to obtain health insurance coverage through the state exchange marketplace.
Narrowing Physician Access Puts Pharma in a Bind
Oncologists have a reputation to maintain - and according to the latest report from ZS Associates, when it comes to fortifying against pharmaceutical sales representatives, the specialty remains characteristically hardboiled for the second year in a row.
Physicians Pass Responsibility for Healthcare Cost Control
A recent poll given to doctors showed that while they admit having some effect on healthcare costs, they felt the majority of health price control remained in the hands of lawyers, health insurance companies, hospitals, pharmaceutical companies, and patients.
The State Debate of Expanding Medicaid
The Affordable Care Act will expand Medicaid eligibility starting in 2014, but a Supreme Court ruling that there will be no penalty for those states refusing to comply, or who later withdraw from the program, has left many state legislators questioning how to proceed.
Accountability Is Driving Force Behind Patient-Centered Care
Accountability will continue to be a key element in the future of healthcare reform. Whether in accountable care organizations, patient-centered medical homes (PCMHs), or other innovative programs for coordinating care-finding a way to drive quality-focused care is essential.
California Health Centers Focus on Quality, Better Patient Outcomes
Community health centers in California are seeing a large disparity in patients' quality of care. The noted variation is cited as a result of the amount of time certain centers have put into improving quality measures, and attributed to their adaptation of electronic health records to monitor patients wellness.
Employer Mandate Delay Raises Concern Over Individual Mandate
Debate recently surfaced following controversial news that the employer mandate of the Affordable Care Act (ACA) would be delayed. However, welcome relief for employers has had little effect on individuals, who must still abide to the ACA's individual mandate or face tax penalties.
Meaningful Use of HIT in the Managed Care Setting
With new models of care delivery, reformation of outdated fee-for-service payment systems, and collaboration of groundbreaking provider-payer partnerships, the changing landscape of the healthcare industry is irrefutable. Yet, the integration of health information technology (HIT) continues to be an area of deliberation for many managed care professionals.
A Push for Collaborative Care Calls ACO Models into Question
In January 2012, 32 healthcare organizations became the first to participate in the Medicare Pioneer Accountable Care Organization (ACO) model. Now, over a year into the initiative, as many as 9 organizations are in deliberation of leaving the program.