Chris Anderson
Independence Blue Cross and regional provider Abington Health announced in late February they would leverage Lumeris' consulting and technology services to enhance their two-year-old accountable care initiative.
In early February, TransforMED announced that its founding president and CEO, Terry McGeeney had retired. Since TransforMED's formation as an offshoot of the American Academy of Family Physicians in 2007, the company has grown from an initial 16 employees to more than 60 today, and has helped more than 1,200 primary care practices in 40 states make the transition from a fee-for-service model to NCQA Level 3 patient-centered medical home.
While Republican members of Congress have announced plans to once again use budget measures to attempt to defund key parts of health reform - including nearly $1 billion the Office of Management and Budget requested for CMS, which presumably would be used for the establishment and operation of state health insurance exchanges - their Republican counterparts who occupy state governors' mansions have begun to sing a different tune.
A report issued this week by the Government Accountability Office reports that the Centers for Medicare & Medicaid Services overpaid the Medicare Advantage program run by private health insurers by between $3.2 billion and $5.1 billion for the years 2010-2012.
When the Centers for Medicare & Medicaid Services proposed, in mid-February, an additional 2.3 percent cut to the rates it pays private insurers for running Medicare Advantage plans in 2014, the reaction from America's Health Insurance Plans (AHIP) was swift, comprehensive and sustained.
On April 1, Highmark Inc. unveiled a group health plan aimed at larger employers and self-insured businesses that provides incentives for members to use providers that exhibit higher quality outcomes, fewer complications and reduced readmissions.
Hospitals in states that don’t expand their Medicaid program as outlined under the Affordable Care Act are facing significant revenue reductions due to regulations that will reduce some Medicare and Medicaid payments in 2014, measures that were written into the law to help pay for the expansion of the insurance program for the poor.
By now, it is no surprise which states have said they won’t expand Medicaid as outlined under the Affordable Care Act. And while there are still a handful of states on the fence, it’s a given that states like Texas, Louisiana, Mississippi and Georgia, among others, were not going to budge.
With no comprehensive program designed to provide long-term care insurance, a panel of experts who convened in March agreed that comprehensive reform has about a five-year window for implementation in order to sufficiently meet the needs of baby boomers.
A report issued this week from the State Health Access Data Assistance Center (SHADAC) and the Robert Wood Johnson Foundation, shows that 59.5 percent of people now receive health insurance through their employer, down from 69.7 percent just 10 years ago.