April 23rd 2025
Accountable care organizations (ACOs) are increasingly playing the role of data sleuths as they identify and report trends of anomalous billing in hopes of salvaging their shared savings. This mission dovetails with that of CMS, which under the new administration plans to prioritize rooting out fraud, waste, and abuse.
Peter B. Bach, MD, Analyzes ACOs and PCMHs
April 2nd 2014Peter B. Bach, MD, MAPP, director, Center for Health Policy and Outcomes, says accountable care organizations and patient-centered medical homes are trends driven by macro issues, which include decreased reimbursement to private practices and drug discounts from the 340B program.
Read More
Making the Evidenced-Based Case for the PCMH
March 31st 2014The Medicare Payment Advisory Commission (MedPAC) recently aired concerns as to whether the patient-centered medical home (PCMH) can serve as a model for providing value-based care. In particular, several members asserted that the medical home model may have a real cost disadvantage for health systems. They explained that without evidence-based research, it is difficult to determine if the model encourages practices to use their cost savings to improve care.
Read More
Fewer Patient Admissions a Symptom of Healthcare 'Transformation,' Study Says
March 24th 2014Figures from 2010 show that 71 Chicago-area hospitals covering seven counties discharged about 1.02 million patients; by 2012, that number had dropped about 5 percent, to 970,000 discharges, according to the January report.
Read More
MedPAC Takes Aim at Outpatient Billing Trend
March 20th 2014As Congress tries to reform Medicare, the program's independent advisor has its own suggestions, including a call to end to what has become a revenue buffer for many hospitals and an integral part of their physician acquisition strategies.
Read More
Mobile Health Clinics in the Era of Reform
This article reviews the mobile clinic sector's impact on access, quality, and costs, and explores postreform opportunities for leveraging them nationally.
Read More
Merck and the Heritage Provider Network forge a new kind of relationship, with the goals of spawning innovation in healthcare delivery and of providing an outline for future collaborations between ACOs and other healthcare stakeholders.
Read More
Post-Treatment Surveillance for Cancer Survivors
March 15th 2014Fox Chase Cancer Center's Crystal Denlinger, MD, presented Optimal Post-Treatment Surveillance: Is More Really Better?, addressing a topic that challenges not only patients and their physicians, but also payers as the nation moves toward a healthcare system defined by the maxim "better quality at a lower cost."
Read More
More Enthusiasm for Newer Melanoma Therapies
March 14th 2014In his talk, Melanoma Guideline Update: New Agents and Opportunities for Treatment, John A. Thompson, MD, of the Fred Hutchinson Cancer Research Center in Seattle, Washington, first showed the preferred list of treatments for advanced or metastatic melanoma: ipilimumab, vemurafenib, dabrafenib, dabrafenib plus trametinib, high-dose interleukin-2, and the drugs-to-come in the category: clinical trials.
Read More
Sorting Through Screening Protocols for Colorectal Cancer
March 14th 2014Who should receive genetic counseling and screening for colorectal cancer (CRC)? And how early should annual colonoscopies happen once those at risk are identified? These are important questions with equally important and complex answers.
Read More
Protecting Bone Health During Cancer Care
March 14th 2014Life-saving therapies that halt cancer can take a toll on the skeletal system, leaving survivors with bone loss or more serious injuries such as broken wrists, ribs, or hips. Watchful attention, screening, and therapy are needed to prevent these outcomes.
Read More
Reform Update: NCQA Previews New Medical Home Standards
March 11th 2014The National Committee for Quality Assurance, under increasing pressure to demonstrate the value of its recognition programs, previewed new patient-centered medical home standards intended to put more emphasis on team-based care, integrating behavioral health and sustaining practice transformation.
Read More
House GOP's Effort to Repeal SGR Takes Aim at ACA's Individual Mandate
March 10th 2014he lower chamber is expected to vote on legislation that would permanently repeal Medicare's sustainable growth-rate formula for physician payment, which might also include a provision to either repeal or delay the ACA's individual insurance mandate as a way to pay for the SGR fix.
Read More