Reimbursement

Researchers found that the state mandates -- which apply to coverage available on the individual market and some group and employer plans -- led to about 12 percent more children getting some kind of treatment for autism. But when compared with the number believed to have the condition, it's not nearly enough, they say.

The cost of long-term, in-home care is greatly underestimated, says a new study from insurance holding company Genworth Financial. In fact, most Americans underestimate the cost by close to 50 percent.

In 2014, when Medicaid expansion and the health exchanges were implemented as provisions of the ACA, children's coverage soared over the previous year's numbers, according to the May study done by the Urban Institute with funding from the Robert Wood Johnson Foundation.

The Centers for Medicare and Medicaid Services is lifting former restrictions and will allow the struggling Affordable Care Act co-ops to obtain needed private capital.

Presenters will describe strategies around consumer engagement, provider contracting, and care coordination models tailored by population data, said Kevin Counihan, CEO of the Health Insurance Marketplace.

Medicaid managed care programs remains vulnerable to improper payments to providers, according to a recent Government Accountability Report to a Senate Committee on Homeland Security and Governmental Affairs, since the information needed to screen providers for inclusion in the program is often fragmented and unavailable.

Just because it's hard to achieve a payer mix that better supports a health system's bottom line, it's not impossible.

A group of more than 2,000 physicians is calling for the creation of a publicly financed, single-payer national health program that would cover all Americans for all medically necessary care. The physicians voiced their support in a proposal published Thursday in the American Journal of Public Health.

Consultants hired by the health system that owns Nantucket Cottage Hospital in Massachusetts made several errors that led to lower wages being reported to Medicare for the hospital, which could potentially lead to a $160 million drop in federal Medicare payments over the next fiscal year for facilities across the state.

The implementation of MACRA and the introduction of the Quality Payment Program is "flexible common-sense approach" for paying physicians, acting Centers for Medicare and Medicaid Services chief Andy Slavitt said at the American Hospital Association's annual membership meeting this week, though the government is actively seeking feedback on the new program.