Reimbursement
Accountable care organizations might be today's hope for grappling with healthcare costs and bumping up quality, but according to one expert, they are doomed to fail without one key element.
The payment of higher Medicare rates to physicians and hospitals in regions that have good health outcomes and lower costs, while reducing payment rates where there is lesser quality and higher costs will not drive individual providers to deliver care more efficiently reports the Institute of Medicine (IOM).
Healthcare is part of the service industry and increased competition amongst providers should lead to cost stabilization and advancements in healthcare services. Unfortunately, multiple barriers limit the healthcare industry from behaving like other service industries.
You should read Dr. Scott Gottlieb's opinion piece in the Wall Street Journal (The Doctor Won't See You Now. He's Clocked Out). He argues that ObamaCare is making independent physician practices obsolete by forcing physicians to work for big hospitals as part of ACOs, is imposing high costs for information technology on those who try to remain independent, and that the Administration's policies will have the ironic consequence of driving up costs since employed physicians are less productive.
New research from the Urban Institute and the Robert Wood Johnson Foundation shows that hospitals can expect to pull in an additional $293.9 billion dollars between 2013 and 2022 if all states opt to expand Medicaid as outlined in the Affordable Care Act.
As healthcare organizations try to make hay with big data, venturing into new areas such as predictive analytics and data discovery, they're ramping up their investments in analytics and business intelligence tools, according to a new survey from Lavastorm Analytics.
The Department of Health and Human Services has to fill some gaps in improper payment reduction and reporting compliance, according to the agency's Office of the Inspector General (OIG).
One example of the dilemmas posed by the rise of personalized medicine is Alzheimer's Disease: the ApoE genetic test can predict early onset of it, but there's still no effective therapy to stop dementia.
A report released in February found that state scope of practice laws and payment policies are two of the biggest challenges to expanding care provided by nurse practitioners.
A survey of small employers by eHealth, Inc. has found many struggling to understand their legal responsibilities and new choices under the Affordable Care Act.