Healthcare Finance Staff
Healthcare IT stakeholders gathered Oct. 14 in Washington for a work meeting, discussing ways IT could help improve transitions in care.
U.S. National Healthcare Expenditures (NHE) are $2.7 trillion in 20111 and are forecasted to grow 34% in five years. This multi-trillion dollar economy will shift its reimbursement paradigm to ICD-102 in under 24 months. ICD-10 will introduce opportunities and risks to hospitals and health plans that may be equivalent to the $148.2 billion to $500 billion in losses3 to the U.S. economy in the mortgage crisis. This is because ICD-10 introduces favorable and unfavorable reimbursement results.
The federal bundled payments effort may promise providers a share in savings when they improve quality and lower costs, but it will likely take the squeeze in fee-for-service Medicare payments to drive many providers to participate in the new delivery model. Private payers have a role in leading on this transformation.
Small and resource-poor, the Western Washington Rural Health Care Collaborative (WWRHCC), has shown it is not afraid to tackle - and complete - big projects, such as building an HIE from scratch and developing a telepharmacy system.
Few seniors are familiar with the Medicare Star Quality Ratings for Medicare plans from the Centers for Medicare & Medicaid Services and even those who do know about them rarely use the information to help select their Medicare plan.
HealthAmerica and Preferred Primary Care Physicians have launched a new pilot program aimed at providing more coordinated and patient-centered primary care and improved communications among patients, physicians and care teams.
Aetna and CVS/pharmacy announced last week a co-branded Medicare prescription drug plan available in 43 states and Washington, DC, in a deal that will leverage the retail base of more than 7,200 CVS and Long Drug stores across the country.
Consumer organizations may find opportunities to partner with health plans in the coming years as more health reform changes take affect in the coming years.
As the Centers for Medicare and Medicaid Services (CMS) prepares to upgrade its computer systems and begins to award incentive payments to eligible meaningful users of electronic health records, the Office of the Inspector General is positioning itself for its monitoring responsibilities. Medicare and Medicaid information systems and data security falls under the oversight of the OIG, as outlined in its work plan for 2011.
Sen. Charles Grassley (R-Iowa), ranking member of the Senate Finance Committee, is pressuring President Barack Obama's administration to defend how it has spent money fighting Medicare fraud, including the addition of new fraud-fighting IT.