Policy and Legislation
Medicare may be overpaying hospitals an estimated $5 billion as a result of the 18-month moratorium on enforcing the controversial two-midnight rule that tells hospitals when patients should be admitted, according to an independent Medicare auditing company.
If global spending becomes the norm in Medicaid, health systems, medical practices, home health and community organizations will face an even greater impetus to collaborate. In the Empire State, some are already starting the journey.
Powerful social forces will drive the healthcare industry to innovate, overcoming institutional and political inertia, says healthcare consultant and futurist Ian Morrison. But things may not get 'serious' until 2018.
A new Medicare prospective payment system for federally qualified health centers offers improved reimbursement rates.
The latest data from the Bureau of Economic Analysis estimate that spending for healthcare services jumped by about $50 billion in the first quarter of 2014 compared to fourth quarter of 2013. But don't listen to those who say we are on track for a 10 percent rise in health spending over the full year.
Although they're not expanding Medicaid under the Affordable Care Act, Texas, Florida and other states are expanding managed care, bringing insurers opportunities as well as challenges, including competition from provider-based health plans.
The proposal for next year's Medicare inpatient payments to hospitals continues the pressure on them, and doubles down on a controversial policy.
Hospitals may have less control over readmissions than clinicians, administrators or federal regulators would like to believe, new research suggests, meaning that the readmissions penalties imposed by the Centers for Medicare & Medicaid Services may be inappropriate.
As lawmakers try to understand the ultimate causes of the recent slowdown in healthcare spending growth, their determinations will eventually translate into policies that will impact healthcare businesses of all types.
Providers of Medicare Advantage and Part D plans: look out. Dozens of plans may soon be terminated.