Policy and Legislation
Identifying an individual's health plan sounds pretty straightforward. Most hospitals have an eligibility system to verify a patient's coverage for a specific set of services from specific insurance companies. But as coverage expands and gets more complex, so do the pressures on hospitals.
Medicare accountable care organizations are having varying rates of success in addressing their patients' diabetes and heart disease, according to government data released Friday.
Lawmakers took another step toward repealing the reviled sustainable growth rate formula that sets physician payment in the Medicare program, but they still haven't figured out how to pay for it.
Statistics released by CMS demonstrate that it is difficult to significantly lower spending and achieve shared savings, even for voluntary early adopters who are keen on healthcare reforms.
The increasing incidence of chronic diseases, aging populations, emphasis on diagnosis and disease monitoring and more advanced testing technologies and practices are driving increased use of clinical lab services.
Healthcare Finance News talked to Debra Miller, director of health policy for the Council of State Governments, about the top five health policy issues states are focused on in 2014.
Reimbursing a physician for their time spent in having end-of-life discussions is not an incentive for a "death panel" decision; it would be compensating them for doing their job. If all we do is compensate physicians for treating people aggressively regardless of the circumstances, we will get what we pay for: an expensive healthcare system run amok.
In a reversal of 30 years' past practice, Medicare may start to disclose what it pays individual physicians for its services to seniors.
Maryland officials have reached what analysts say is an unprecedented deal to limit medical spending and abandon decades of expensively paying hospitals for each extra procedure they perform. If the plan works, Maryland hospitals will be financially rewarded for keeping people out of the hospital.
When discussing solutions to the problem of primary care shortages, nurse practitioners and physician assistants are top of mind. A law that took effect the first of the year in California is putting the spotlight on another option: pharmacists.