Reimbursement

In an effort to lower the number of out-of-network referrals for outpatient surgical procedures, Aetna has launched a program that will actively alert both members and their doctors if they are leaving the insurer's network for care and work to shift the referral to an in-network provider.

A new national program from Aetna that seeks to lower the number of out-of-network referrals for outpatient surgical procedures will actively alert both members and their doctors if they are leaving the insurer's network for care and work to shift the referral to an in-network provider.

As it looks to maintain Medicaid member access to primary care doctors, HHS announced last week  a two-year, $11 billion program that will help states bring Medicaid payments for primary care services in line with those paid by Medicare.

In a move that anticipates the increase in the number of people insured through state Medicaid programs as a result of the Affordable Care Act, the U.S. Department of Health and Human Services announced yesterday a two-year, $11 billion program that will help states bring Medicaid payments for primary care services in line with those paid by Medicare.

While some $560 million in federal health information exchange funding may soon run dry, changing reimbursement models mean market-driven growth will continue, says a new report on HIEs from Chilmark Research.

The College of Healthcare Information Management Executives (CHIME) on Wednesday submitted comments on ICD-10 proposed rulemaking to Health and Human Services Secretary Kathleen Sebelius. CHIME urged HHS to remain committed to ICD-10, while calling the one-year delay an appropriate "middle ground" for all stakeholders.

AHIMA has said it before, and it is saying it again. Delaying ICD-10 deadlines is not a good idea.

A new study from Rand Corp. published in the May edition of Health Affairs indicates that consumer-directed health plans could save $57 billion annually if they grew to comprise 50 percent of all employer-sponsored health insurance in the U.S.

The Hospital and Healthsystem Association of Pennsylvania (HAP) released new data last week showing Medicaid payments falling short of costs by $5.28 billion between 2011 and 2015.

Mobile health, or mHealth, is poised to explode over the next decade, says Chad Udell, managing director of Float Mobile Learning, a mobile learning consulting, strategy and research firm based in Morton, Illinois.