Reimbursement
The efforts of Highmark, Pennsylvania's largest health insurer, to acquire the struggling hospital operation West Penn Allegheny Hospital System has brought into sharp focus the acrimonious relationship between the insurer and the region's dominant hospital operator, University of Pittsburgh Medical Center (UPMC).
Findings from a Harvard University study reported in the New England Journal of Medicine examining one-year results for Blue Cross Blue Shield of Massachusetts' global payment initiative shows the program is lowering medical spending while improving quality of care.
The Affordable Care Act is placing a huge emphasis on the forward progress of delivery models that save lives, improve care and cut costs. One such model is the patient-centered medical home model.
HealthInsight, a Salt Lake City-based non-profit, announced Thursday that it will launch a health information exchange in Nevada. HealthInsight is a regional extension center and an ONC Beacon Community.
A home care advocacy organization says the Office of Inspector General's recent report about the unnecessary provision of powered wheelchairs to Medicare beneficiaries is misleading and that the real problem is a flawed documentation process.
The federal Pioneer Accountable Care Organization Model that was announced last May is asking too much of providers, too soon, according to Brian Yeaman, chief medical information officer of Oklahoma-based Norman Regional Health System.
NaviNet, the real-time healthcare communications network, has announced NaviNet Doc Xchange, which enables electronic document exchange among providers, insurers and others, reducing mail- and fax-based submission.
Although CMS made changes to the billing of concurrent therapy and higher levels of therapy at skilled nursing facilities, Medicare payment rates increased by $2.1 billion between the last six months of 2010 to the first half of 2011, said a report from OIG.
Some form of shared savings and bundled payments will become a reality no matter if it looks like the current proposals of the Centers for Medicare and Medicaid Services (CMS) or a version that is developed for a Republican agenda because the current healthcare cost trends are unsustainable.