Community Benefit

With the increasing costs of a growing Medicare population and of an American population that is living longer but with more chronic disease, the U.S. healthcare system needs to utilize better care coordination and payment reform to keep costs down, according to a report from the American Hospital Association (AHA).

Many safety-net hospitals that treat a higher number of lower-income patients than other hospitals are worried that the Hospital Readmissions Reduction Program (HRRP) will have a disproportionate impact on their reimbursements due to their traditionally higher readmission rates. A new Commonwealth Fund analysis confirms those fears.

When patients have access to after-hours services with their primary care provider, emergency room usage is significantly lower and fewer patients go without needed medical care, according to a study by the Center for Studying Health System Change (HSC) released last week by Health Affairs.

Consumer-directed health plans with high deductibles typically exempt recommended preventive care such as annual physicals or screening tests from the plan's deductible or require only a small copay as a way to ease financial barriers and encourage patients to seek care. However, many patients don't understand their plan benefits for preventative office care and tend to avoid visits altogether.

United Health Foundation's 2012 America's Health Rankings revealed that while Americans are living longer, unhealthy behaviors and preventable illnesses threaten quality of life and add to healthcare costs.

An annual list of issues facing physicians doesn't offer any surprises. The Physicians Foundation released today its Physicians Watch List, five issues the nonprofit organization has identified as likely to have the most impact on doctors in 2013.

Jeffrey Brenner, MD, is on a mission to improve the quality and cost of healthcare delivery in his community. He is particularly focused on "super-utilizers," the segment of the population that uses a disproportionately high amount of hospital and ER services. Brenner spoke recently with Healthcare Finance News Editor Rene Letourneau about his research and his views on the nation's failing healthcare systems.

With healthcare costs and chronic disease rates continually rising each year, it will only become more difficult for both employees and employers (who must pay to insure their employees) to keep up financially, which is why successful employee wellness programs are becoming an increasingly important asset in the workplace.

A new study reveals that financial risk plays a role in underuse of hospice care in the United States.

Employee wellness plans can be great cost savers for both health insurance companies and employers in the long run, but with new proposed rules and regulations around wellness plans set to begin on Jan. 1, 2014, employers and insurers are going to have to be careful about following more legal requirements.