Reimbursement

BALTIMORE - For the first time, Medicare patients can see how often hospitals report serious conditions that develop during an inpatient hospital stay and possibly harm patients with important new data about the safety of care available in America's hospitals added today to the Centers for Medicare & Medicaid Services' (CMS) Hospital Compare website. The Hospital Compare website can be accessed at www.HealthCare.gov/compare.

Many children covered under Medicaid and CHIP needing care coordination and access to care networks had difficulty getting the needed services according to a report released by the Government Accountability Office.

Kaiser Permanente this week has opened a new Center for Total Health near Capitol Hill. Kaiser executives said they hope the center will be a place or bringing together history, innovation, and state-of-the-art technology.

A new study, reported in the American Journal of Managed Care, seems likely to add more heat to the continuing medical loss ratio controversy. The Accountable Care Act effectively mandates that health insurers achieve MLRs of 85 percent for large group business and 80 percent for small group and individual business, with insurers not meeting these thresholds required to make rebates to affected policyholders. However, the ACA allows HHS to issue a waiver if the requirement would disrupt a state's insurance market.

A white paper released by MedeAnalytics shows health insurance plans should benefit from the proposed rule on accountable care organizations.

The Council of Accountable Physician Practices, an affiliate of the American Medical Group Association, has announced a new public education program aimed at providing resources and information about the value of care coordination and accountable care to national healthcare reform.

A series of new reports from the RAND Corporation outlines the impact that national healthcare reform will have on individual states, estimating the increased costs and coverage that are expected in five diverse states once reform is fully implemented in 2016.

CHANDLER, AZ - The Managed Care Executive Group, a national organization of U.S. senior health plan executives, met last week in Arizona to discuss the top issues that health plans face in 2011.

Humana Cares recently launched a pilot project aimed at better care for members with congestive heart failure.

The Arizona House approved a measure to restore Medicaid funding for organ transplants and the state Senate was expected to also approve the measure. Governor Jan Brewer took heavy criticism for cutting the money from the sate budget late last year, as the state grappled with a crushing budget deficit.