Chris Anderson
Whether they're called accountable care organizations or patient-centered medical homes, healthcare organizations will be transforming in the coming years to new methods of providing care. But are all organizations ready for the changes needed to get there?
According to the Kaiser Family Foundation, Medicare Advantage plans with high quality ratings are clustered in certain states, leaving beneficiaries in a handful of states with few, if any, options for choosing a highly rated plan.
CIGNA and the Piedmont Physicians Group, part of Atlanta-based Piedmont Healthcare have launched an accountable care organization pilot program, designed to provide a comprehensive, accountable and collaborative approach to medical care.
According to a report in the Sept. 7 issue of the Los Angeles Times, California state insurance regulators are seeking fines against PacifiCare for problems including failure to pay doctors, loss of medical records, mismanaged claims and ignoring calls to correct those problems.
Innovent Oncology, a division of US Oncology, has engaged the actuarial and consulting firm Milliman to help develop risk contracting methodologies - including episode rates, bundled payments and capitation - to help identify potential areas where oncologists can improve quality of care while lowering health costs.
Health and Human Services Secretary Kathleen Sebelius has announced that nearly 2,000 companies and unions have been accepted into the Early Retiree Reinsurance Program, which was rolled out on Aug. 31.
A new report from the New England Journal of Medicine indicates that 14.1 million children, or 19.3 percent, were underinsured by their health insurance plans in 2007, and that those with private insurance were more likely to be underinsured (24.2 percent) than children with public health insurance (14.7 percent).
A recently published Consumers Union report titled "How Much is Too Much?" contends some non-profit Blue Cross and Blue Shield plans have racked up large cash surpluses while continuing to aggressively raise insurance rates.
The Ohio Association of Home Medical Equipment Services has announced its opposition to the Center for Medicare and Medicaid Services' competitive bidding plan for Medicare reimbursements, joining a host of other organizations that contend the plan is unsustainable will put provider organizations out of business and, as a result, restrict access to needed medical equipment and care.
Emdeon, Inc., a provider of healthcare revenue and payment cycle management solutions, has entered a strategic relationship with Noridian Mutual Insurance that's aimed at increasing Emdeon's penetration in the public payer sector.