Providers

An analysis of provider networks offered in the Affordable Care Act's marketplaces found large variation of the prevalence narrow networks among the states, according to researchers at the University of Pennsylvania.

With various healthcare stakeholders having different wants and needs from the healthcare system, meetings that bring all parties together in one room are important, according to Suzanne F. Delbanco, executive director of Catalyst for Payment Reform, and keynote speaker at the spring live meeting of the ACO and Emerging Healthcare Delivery Coalition.

Access to workplace wellness programs has been on the rise, but employers and providers still face steep challenges that can prevent these programs from being worth the investment.

Increasing health insurance enrollment is only one part of the goal of the Affordable Care Act-the law also aims to improve population health and lower healthcare costs, but less attention has been paid to these critical steps.

The Office of the National Coordinator for Health Information Technology will be awarding $38 million to 20 organizations in 3 health information technology grant programs working to further nationwide efforts to achieve better care, smarter spending, and healthier people.

A report released by the healthcare research group Avalere Health claims that health insurance exchanges have a significantly narrow network compared with their commercial counterparts.

Quality of care and relative resource use for patients with diabetes are not necessarily positively related. Further, the relationship varies by year, plan type, and region.

The findings of inadequate access to providers and outdated information were no surprise to healthcare advocates. Many of the issues are addressed in a giant proposed rule issued by CMS in late May.

This is the third year that CMS has released Medicare payment data, and this year the agency added information on prescription drugs.

The suits are on behalf of providers and health insurance customers and involve some famous plaintiffs' attorneys.

The authors discuss the success of the Pioneer ACO model and the Comprehensive Primary Care Initiative, among others. They outline an agenda that includes engaging managed care stakeholders, so that both public and private payers are moving toward value-based payment.

The American Journal of Managed Care's Patient-Centered Oncology Care meeting is an important event for anyone interested in "crossing the chasm" that appears between providers and the rest of the healthcare world, explained Peter P. Yu, MD, president of the American Society of Clinical Oncology.

Even though patient-centered medical home models are being implemented by multiple provider practices and health systems, little is known about what facilitates their implementation.

In 2014, Medicare telemedicine reimbursement totaled $13.9 million, a number that has steadily increased since 2008, according to the Robert J. Waters Center for Telehealth and eHealth Law.

Industry experts at the National Association for Healthcare Quality's National Quality Summit highlighted improving care through successful care transitions.

Despite a general sense that engaging in big data analytics is important for success in the current health information technology landscape, 51% of organizations do not truly know what kind of data-or how much of it-they need to collect

Nearly 40% of healthcare providers treating Medicare patients will have their payments docked 1.5% this year because they didn't submit data on patients' health to the government, CMS said.

Enlisting electronic health record (EHR) super users to provide support to employees is not enough to foster EHR implementation success-super users' behaviors can be an important influence, researchers from Yale University found.

Patients with multiple long-term health conditions are more likely to report poorer experiences in primary care than those with fewer health problems, according to recent findings by researchers from the University of Cambridge and RAND Europe.

A general session at the Community Oncology Conference, Community Oncology 2.0, Moving Forward on Payment Reform, was a panel discussion that saw participation by 2 providers and a payer.

Nursing home operators are asking legislators for a "carve out" from the state's managed care plan. The AARP says this will retain a system that keeps state funds way from caring for the elderly in their homes, which most Louisiana residents prefer.

Measuring value in cancer care matters, but so does creating a structure that makes sense to stakeholders who use it. The current issue of Evidence-Based Oncology features an article on how a regional consortium of providers, payers, patient partners and researchers developed a set of metrics together, from the bottom up.

Having people from different parts of the diabetes care equation talking together at the 3rd Annual Patient-Centered Diabetes Care Meeting is what will move the industry forward, according to Robert A. Gabbay, MD, PhD, chief medical officer and senior vice president at Joslin Diabetes Center and the editor-in-chief of Evidence-Based Diabetes Management journal.

A new coalition of consumers, healthcare providers, and industry launched the Clear Choices Campaign on April 9 to advocate for more transparent, accountable, and consumer-friendly health markets.

The Workgroup for Electronic Data Interchange sent a letter to HHS Secretary Sylvia M. Burwell on March 31 explaining that the 1-year delay for implementation of the International Classification of Diseases, Tenth Revision may have done more harm than good.

With a focus on improving quality while maintaining the cost of care, providers and payers are evaluating various payment models that could improve patient outcomes using evidence-based treatment at lower costs to the healthcare system.

Although healthcare stakeholders view comparative effectiveness research (CER) as important to healthcare, respondents to a survey from the National Pharmaceutical Council admitted that they haven't yet seen the impact of CER.

The Supreme Court of the United States ruled on Tuesday that providers cannot sue states over low Medicaid reimbursement rates, overturning the decision of the lower court.

More than $3 billion was returned to the Medicare Trust Fund in 2014 from individuals and companies attempting to defraud federal health programs, according to an announcement by HHS.

Keeping afloat by understanding the Affordable Care Act, managed care, consumerism, and transparency from the perspective of purchasers, providers, and consumers.