Reimbursement
With 20 percent of the state uninsured, Nevada's state exchange is aiming to offer affordable coverage and be financially self-sustaining, while neighboring California takes bids for its HIX, and insurers and state officials await a post-election rule-making flood from Washington.
The National Quality Forum (NQF) announced nov. 5 it has endorsed 10 behavioral health quality measures, addressing alcohol and tobacco abuse, antipsychotic medication adherence, and post care follow-up after hospitalization for mental illness.
According to a new report from the National Association of Public Hospitals and Health Systems (NAPH), hospitals could possibly face a $53.3 billion increase in uncompensated care costs by 2019 if states forgo expanding their Medicaid programs as part of the Affordable Care Act (ACA).
The Government Accountability Office (GAO) has found that Medicare-covered advanced imaging services increased between 2004 and 2010, and that unecessary provider self-referrals cost $109 million in 2010.
UnitedHealth exits S.C. Medicaid market; Vermont urges state workers to enroll their kids in CHIP; and Washington Medicaid will cover autism therapy in this week's Medicaid Digest.
Physicians who treat Medicaid patients will get a pay raise in two months when Medicaid reimbursement rates becoming equal to Medicare reimbursement rates for primary care services.
On Thursday, the American Hospital Association (AHA) and four other hospital systems filed a suit against the U.S. Department of Health and Human Services (HHS) for refusing to meet its financial obligations for hospital care services provided to certain Medicare patients.
Washington State has received federal approval to test a managed fee-for-service model for Medicaid-Medicare eligible patients in a demonstration that is expected to save up to $14 million over the next five years.
Many states are lagging in how they measure and collect eligibility and enrollment information and could benefit from more streamlined coding sets, according to a policy brief by the Maximizing Enrollment project, led by the Robert Wood Johnson Foundation.
A new global study by the IMS Institute for Healthcare Informatics shows that the use of healthcare IT to increase medication adherence could be a key factor in saving some $500 billion in healthcare spending worldwide.