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The move away from inpatient care towards services provided outside of the hospital setting is leading many healthcare systems to sell off properties owned by their hospitals in an effort to scale back and raise some extra cash.
States that expand get billions of additional federal dollars, but many Republican lawmakers are loathe to say yes to the Obama administration.
$52 billion and growing is the trend in high-cost pharmacy benefits, as more and more Americans use prescription drugs with expenses exceeding the U.S. median household income.
CVS is planning to open more than 100 new clinics this year -- recent ones opened in Nebraska, New Mexico and Wisconsin -- and could surpass 1,500 locations by 2017.
The combined entity, dubbed Hackensack Meridian Health, will have 11 hospitals, 25,000 employees and another 6,000 physicians on staff.
In the late 1990s you could have taken what hospitals charged for inpatient chemotherapy and bought a Ford Escort econobox. Today average chemo charges are enough to pay for a Lexus GX SUV, not even counting the price of anti-cancer drugs.
The L.A. County program allows for a Web-based conversation between primary care doctors and specialists that can include the exchange of medical records and photographs.
When hospitals send invoices with charges that seem to bear no relationship to their costs, the Pennsylvania firm tells its clients (generally medium-sized employers) just say no.
While once there were no books, conferences and even curriculum dedicated to the management methodology, now there are dozens of tools available.
If nothing else, the collapse of multi-million dollar state-based exchanges has created a PR problem for health reform, but that's only part of the issue.