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Most of the recent public attention paid to the federal Medicaid program has focused on the question of whether or not states will participate in the program’s expansion as allowed in the Affordable Care Act.
It may not be quite at epidemic levels, but merger mania has definitely taken hold in the healthcare field, and most certainly in New England.
One of the latest examples is the proposed partnership of Beth Israel Hospital in Boston, the Lahey Clinic of Burlington, Mass., and Atrius Health, a Newton, Mass.-based consortium of Harvard Vanguard Medical Associates. Atrius Health is the largest physician organization in Massachusetts, with 1,000 physician members.
Healthcare organizations have often been criticized for being slow to adapt to changes in the marketplace. A recent accelerator program spearheaded by Independence Blue Cross (IBC), Penn Medicine and DreamIt Ventures hopes to change that by backing 10 innovative healthcare startups. And while none of these startups are likely to revolutionize medicine, they do suggest that there are many entrepreneurs with promising solutions that may reduce the cost of care while maintaining its quality.
Evan Schwartz, founding partner of New York-based law firm Quadrino Schwartz, said his organization used to see the occasional case of private insurers retrospectively auditing health care providers – they only litigated about 10 or so each year.
Health insurer Priority Health has announced it has contracted with Healthcare Blue Book to publish cost and quality information for more than 300 procedures by facility and physician for its insurance members in Michigan.
A recent report by Frost & Sullivan found that the market for revenue cycle management applications and services will grow 61 percent between 2012 and 2017 ($1.9 billion to $3.07 billion), as hospitals upgrade platforms to address coming cuts in Medicare and Medicaid payments under the Affordable Care Act.
For innovators, the experience at the typical industry conference exhibit hall is usually focused on selling their newly designed products and services.
Revenue cycle integrity is critical to financial performance and will be even more so with accountable care organizations, bundled payments and other changes coming with healthcare reform.
Nonprofit hospitals in California are facing the possibility of having to prove they provide the necessary amount of charity care to justify their tax-exempt status.
Like it or not, a new healthcare landscape is taking shape that runs counter to just about every convention the industry has ever known.