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Federal regulators are trying to set expectations and a tentative schedule for public exchange plans in 2015; they're also proposing a new approach to network adequacy and essential community providers, after complaints from consumers and providers in a few markets.

Measuring the patient's experience of care will help EMS be perceived as modern healthcare providers.

Billions of dollars are wasted and thousands of lives lost each year through inefficient or ineffective medication management. It has been estimated that the misuse of prescription drugs in our healthcare system is up to a $300 billion problem annually.

The value of the mammogram is being questioned after 1 study found that the mortality rates resulting from breast cancer were the same in women who got screened and those who did not.

The technological underpinnings for an accountable care organization (ACO) include all the basic healthcare IT you have heard so much about, including electronic health records (EHRs), electronic medical records (EMRs), and health information exchange (HIE) for transmitting patient data between participating organizations that are not necessarily all on the same EHR.

The American Medical Association pledged its full support for legislation repealing the Medicare sustainable growth-rate physician payment formula.

Select employers will have until January 1, 2016, to comply with a health insurance mandate under the Affordable Care Act(ACA). Originally, employers with 50 to 99 workers would have faced a penalty if they did not offer health insurance to their employees in 2014.

Once limited to filling and dispensing drugs, pharmacists are increasingly providing direct care to patients. Across the country, they are working with doctors to give immunizations and help patients safely manage medications.

Providing a solid base of primary-care service and coordinating specialty care for high-risk patients has been advocated as a method of lowering overall healthcare costs. Doing so would presumably reduce repeat hospitalization and emergency department visits.

The Obama administration announced Monday it would give medium-sized employers an extra year, until 2016, before they must offer health insurance to their full-time workers.

Susan Fox, director, business and product development, US Script, Inc, says the prescription benefit provides a unique opportunity to attract, attain, serve, and retain members in exchange insurance plans

Earning Too Little for Health-Law Subsidies but Ineligible for Benefits Under Existing Medicaid Programs

The CMS is extending the deadline for physicians and other eligible professionals to attest to meaningful use for the Medicare EHR incentive program for the 2013 reporting year and is offering some hospitals a second chance at receiving payment-as well as possible relief from the program's 2015 penalties for failing to comply in 2013.

With hospitals vehemently opposed to more Medicare cuts to fund the bipartisan legislation unveiled Thursday that would permanently end the annual charade around physician pay cuts, Congress may have to enact some form of payment or tax reform if it expects to get the job done this year.

Testing the entire genetic makeup -- or all the DNA -- of tumor cells from women with advanced breast cancer may help identify patients who could be helped by specific treatments, according to new research.

The revision process for ICD-11 is currently underway and the final version will be released in 2017, according to a fact sheet from the World Health Organization.

Arkansas' plan for expanding Medicaid by buying private insurance policies for the poor instead of adding them to the rolls was heralded as a model for convincing more Republican-leaning states to adopt a key part of President Barack Obama's health care overhaul.

A bipartisan agreement has been reached regarding the sustainable growth rate (SGR) and Medicare reimbursement model.

As out-of-pocket medical costs grow for many Americans, the insurance industry is offering a way to help and, at the same time, expand its business: by selling supplemental policies that may fill the gaps for consumers.

Here's more fodder for the debate over whether older, sicker members will swamp insurance plans created by the Affordable Care Act.

Drugstore giant CVS Caremark's decision to stop selling tobacco products at its stores is being hailed as a victory among public health advocates, a move they predict will force CVS competitors to follow suit as they look to play a growing part in the delivery of the country's healthcare.

This week AJMC is covering session highlights from the PBMI Annual Drug Benefit conference.

This week AJMC is covering session highlights from the PBMI Annual Drug Benefit conference.

Healthcare providers say Medicare is going to short-change them on patients who spend fewer than two nights in the hospital, and delaying implementation of a new payment policy until October won't change that.

A new federal rule on the exchange of health data removes legal barriers that stop medical laboratories from providing lab test results directly to patients and their designees, such as developers of their personal health records systems. The rule preempts laws in 13 states and lifts a federal exemption effective in 26 more states.

This week AJMC is covering session highlights from the PBMI Annual Drug Benefit conference.

Residents across Indiana are treading lightly when considering buying health insurance through the federal health exchange as they move toward a March 31 deadline to enroll.

New Medicaid patients in Oregon failed to use their benefits effectively because they did not understand how to use insurance or health care, according to a study.

The Obama administration said Friday that it is considering ways to extend into 2015 efforts to prevent consumers whose health coverage changes from suddenly losing access to particular doctors.

If a recent Black Book survey of payers, hospitals, and physicians turns out to be true, then the number of public health information exchanges (HIEs) is likely to dwindle in the years ahead.