Anthony Brino
Two greater Chicago health systems are joining forces to create what could become Illinois' third largest health network. But don't call it a merger.
MedPAC is out with its 15th annual mid-year report, offering advice for Congress and the Department of Health and Human Services to improve and sustain the senior's health program as it enrolls millions of retiring baby boomers. Here's what hospitals need to know about the commission's latest thinking.
"Clinical integration" and "organizing for value" are two key themes at the HFMA 2014 ANI conference. Both are crucial in preparation for the transition from a fee-for-service reimbursement system. Here's an example of how one health system is preparing, by teaming with a health plan on a new care management venture.
The breakthrough hepatitits C drug Sovaldi has brought the high price of specialty pharma to recent public attention. But less examined are proactive approaches that could be used to curb the growth trend without depriving patients of needed therapies.
Medicare's ACOs have had mixed early outcomes, but some commercial accountable care ventures, including PPO plans, are showing promise.
Hospitals in states that have expanded Medicaid eligibility under the Affordable Care Act are already bringing in fewer self-pay and charity care patient cases, according to an analysis by the Colorado Hospital Association.
The American Hospital Association is asking federal Medicare leaders to stem the practice of using sample hospital audit data to extrapolate overpayments eligible for recovery. The lack of clarity regarding standards for short patient stays has clouded the issue.
States' taxing of Medicaid managed care organizations to raise revenue for state-share Medicaid payments may be illegal, according to the HHS Inspector General. If so, this raises serious questions that could shake up MCO financing models.
One third of Pennsylvania's hospitals had negative operating margins in the 2013 fiscal year, according to the Pennsylvania Healthcare Cost Containment Council, an independent state agency. The crisis is forcing health systems to rethink organizational mergers and management.
As the Department of Veterans' Affairs scandal grows, scrutiny of wait times at civilian hospitals and clinics is bound to as well. Health systems might start reviewing their own access metrics.