Reimbursement

The earlier hospitals begin to plan and strategize for how they will handle the healthcare environment once health insurance exchanges are operational, the better, said Purva Rawal, senior manager of health reform at Avalere Health, during a webinar Thursday.

Now that the Affordable Care Act has survived the Supreme Court ruling and the presidential election, one of last year's other big issues is moving to the forefront for 2013: reimbursements.

Managed care insurer Health Net reported 2012 fourth quarter earnings down 91 percent from the previous year, after litigation, severance costs and declines in commercial enrollment.

The Green Mountain Care Board (GMCB) recently outlined its second year of work as it helps guide the state toward a publicly financed single payer healthcare system by 2017.

Web insurance marketplace and health insurance exchange company Connecture announced earlier this month that it had acquired DRX (formerly DestinationRx), in a deal that will join two companies that offer online enrollment and insurance marketplaces for commercial plans and government insurers alike.

Ahead of guaranteed issue regulations taking effect in 2014, a new study has found that about 20 percent of individual insurance applications are rejected nationwide.

As Vermont lawmakers start their annual budget-making process, the Green Mountain Care Board (GMCB) has outlined its second year of work as it helps guide the state towards a publicly financed single payer healthcare system by 2017.

Mobile health is one of the more transformative developments in healthcare, according to Patricia Abbott, associate professor of nursing at the University of Michigan, School of Nursing, Division of Nursing Business and Health Systems. "The real winners will be the ones who grab on in the front end, and don't wait," she says.

Collaborative efforts, including tracking Medicaid beneficiaries who frequently use emergency departments and adopting electronic tracking systems to exchange patient information, are among the ways states can cut Medicaid costs, according to a new report by the Washington Health Care Authority (HCA).

I was recently speaking to the clinical leaders of a mid-sized hospital, and a senior administrator posed the question, "should we require our doctors and nurses to get flu shots?" The answer, I said, is yes, and it isn't just to prevent the flu. It's to get into the habit of making our folks do the right thing when it comes to patient safety.