Susan Morse
The news comes as more health plans move from broad networks and straightforward reimbursement approaches to narrow networks and value-based payments.
The Centers for Medicare and Medicaid Services on Monday announced a $32 million initiative to drive down the number of uninsured children by supporting outreach to get families with children eligible for Medicaid and the Children's Health Insurance Program enrolled.
Under the model, hospitals in 67 geographic areas will receive additional payments if quality and spending performance are strong, or if not, have to potentially repay Medicare for a portion of the spending for care for a lower extremity joint replacement procedure.
Averting a strike planned for Monday, Kaiser Permanente and the National Union of Healthcare Workers on Sunday reached a tentative agreement for a 6 percent wage increase during the first year of a three-year contract for mental health employees working in Northern California.
The goal is to increase the approximately 59 percent of Humana individual Medicare Advantage members who have primary care physicians participating in value-based relationships, to 75 percent by the end of 2017.
Organizations were eligible to submit proposals for two types of projects: those that address issues of quality occurring within the local service area; and those focused on expanding the scope of quality improvement interventions with proven, but limited success.
Over 1.1 million applications were submitted to Healthcare.gov from Nov. 1 through 7, CMS reported.
Prime Healthcare Services has won in its bid for the financially struggling Saint Michael's Medical Center in Newark, New Jersey, according to Saint Michael's Board of Directors.
The nonprofit co-op Health Republic Insurance of New York owes hospitals within the Greater New York Hospital Association more than $150 million, according to a November 11 letter from President Kenneth Raske to member CEOs.
Todd Craghead, who oversees $5 billion in annual gross patient revenue for the Utah health system, is leading the system's consolidation of revenue cycle functions across 22 hospitals and more than 100 physician clinics.