Reimbursement

Kaiser Health News has an interesting piece in which it quotes the answers of six health care system "experts" to what happens if the Affordable Care Act's individual mandate is found unconstitutional. (The GAO posed a similar question to a wider group earlier this year, and published its much more extensive findings in a February 25 letter to a Senate Appropriations subcommittee.)

To aid health entities in managing the HIPAA 5010 and ICD-10 mandates, CMS has made available what it's calling "timeline widgets."

Independence Blue Cross and Blue Cross Blue Shield of Michigan announced a partnership intended to expand Medicaid insurance and services nationally through a combined acquisition of AmeriHealth Mercy, which serves nearly 800,000 Medicaid members in three states.

IBM is teaming with WellPoint to develop the first commercial applications of its Watson technology, with an eye toward bringing evidence-based information to care providers.

The total cost for children’s hospital stays in 2009 was $33.6 billion, or about 9 percent of overall hospital costs, according to a new report from the Agency for Healthcare Research and Quality.

Ten New Hampshire hospitals have filed a federal lawsuit against the state of New Hampshire, seeking to enjoin the state from enacting its fiscal 2012-13 budget.

Health plans are incorporating technologies to help them squeeze out administrative expenses from the premium revenue they bring in to meet medical loss ratio requirements designed to assure transparency and value for consumers' premiums. Under the Patient Protection and Affordable Care Act, large insurance companies must not spend more than 15 percent of premium revenue on administration and small insurers 20 percent, beginning this year.

I am very impressed that the federal government is willing to experiment with a variety of types of bundled payment models to determine what will work best and what makes sense for different parts of the country.  This is something new for the federal government and they have not been open to this before. They are reaching out to those in healthcare to essentially tell them what will work and to collect ideas about how exactly to do this. 

Perhaps this is to be taken as a sign that the Centers for Medicare & Medicaid Services (CMS) will not, as some healthcare IT pros no doubt are still hoping, push back the compliance deadline for ICD-10.