November 21st 2024
Despite significant progress in expanding health insurance coverage since the Affordable Care Act (ACA) was enacted, millions of Americans still face critical gaps in access to and affordability of health care.
ACO Coalition Members Share Best Practices
June 24th 2014The American Journal of Managed Care followed up the first meeting of its ACO and Emerging Healthcare Delivery Coalition with its first interactive conference call, which was open to all members. Anthony Slonim, MD, DrPH, a Coalition co-chair who on July 1 will become president and CEO at Renown Health in Reno, Nev., moderated the roundtable discussion.
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Addressing Disparities in Minority Populations Starts with Better Data
June 14th 2014Two studies presented at the American Diabetes Association's 74th Scientific Sessions show that evaluating diabetes risk and patient health by nation of origin and ethnic background yields richer insights into how the disease affects populations.​
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HHS Fights Back to Keep Expanded 340B Drug Discounts
June 13th 2014The drug industry scored a victory last month against the Obama administration's plans to give hospitals millions of dollars in discounts through the 340B program on orphan drugs. But HHS is sticking to its position that the Patient Protection and Affordable Care Act promises breaks on the expensive drugs when they're used for non-orphan indications.
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Latest CMS Data Drop Shows Regional Variation in Spending on Inpatient, Post-Acute Care
June 4th 2014The CMS' release of per capita spending for Medicare beneficiaries shows that some states, particularly in the South, Midwest and Mid-Atlantic, are spending significantly more on inpatient and post-acute care than northern and western states.
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Hospital Charges Surge for Common Ailments, Data Shows
June 3rd 2014Charges for some of the most common inpatient procedures surged at hospitals across the country in 2012 from a year earlier, some at more than four times the national rate of inflation, according to data released by Medicare officials on Monday.
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Doc-Led ACOs Show Promise for Patients, Payers
June 2nd 2014In the search for meaningful patient care improvements and sustainable financing, some independent physician groups are charting unique approaches that may offer models for payers and providers in the age of cost-containment and risk-sharing.
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Will Congress Abolish the 96-Hour Rule?
May 29th 2014There are rumblings that federal lawmakers may be willing to repeal Medicare's burdensome rule requiring physicians in critical access hospitals to make an educated guess that the patients they're admitting will be either discharged or transferred in less than four days.
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CMS Issues Final Ruling For Medicare Part D
May 21st 2014A CMS ruling would force healthcare providers to enroll in Medicare by June 1, 2015, if they plan to prescribe medications that are paid for by the program. The agency said in a report that changes to Medicare Part D were necessary in order to cut down on inappropriate prescription practices and to improve patient safety.
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Low-Value Services Cost Medicare Billions
May 13th 2014Emerging health models all focus on 2 things in transforming care delivery: quality and cost-effectiveness. In order to achieve those standards, providers must adopt practices which support value, and cut those services or procedures that don't.
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Obamacare Question: Ditch Employer Mandate?
May 12th 2014A left-leaning think tank whose research is often taken seriously by backers of the health-care overhaul has published a paper suggesting the administration should scrap the health law's requirement that employers offer coverage or pay a penalty.
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Editor Shares Practical Road Map Through Maze of Therapy Options
May 7th 2014Attendees at the 167th Annual Meeting of the American Psychiatric Association (APA), convening at the Jacob K. Javits Center in New York City, appreciated Sunday's opportunity to hash out practical day-to-day issues at Meet the Author: Evidence-Based Guide to Antidepressant Medications and Antipsychotic Medications, with editor Anthony J. Rothschild, MD, director of the Center for Psychopharmacologic Research and Treatment, at University of Massachusetts Medical School.
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Limited Medicare ACO Quality Data Show Sharp Variations in Performance
May 7th 2014Since the Obama administration launched its accountable care initiative as part of healthcare reform in 2012, the CMS has announced which hospital and physician networks in one of the programs have met cost targets and received shared savings. But so far, it has published little data on quality of care delivered by these networks, which were designed to deliver better care as well as lower costs for Medicare patients.
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