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.
For the second time in two months, Congress has turned to an extension of Medicare sequestration as a funding mechanism -- a troubling new trend for Medicare providers.
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.
As a healthcare consumer, am I most interested in short-term complications and readmission rates or am I interested in getting cured of whatever I have? The recent hullabaloo over narrow networks and whether a more expensive hospital is worth it or not seems to miss the bigger point.
Hospitals can take a deep breath, and rest easier for at least six months. CMS is delaying enforcement of its "two-midnight" policy until after Sept. 30.
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 Congressional Budget Office has raised the specter that reform to the Medicare physician fee schedule statutory update formula could increase the likelihood that the ACA's Independent Payment Advisory Board mechanism would be triggered potentially resulting in as much as $0.6 billion in Medicare provider cuts.
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.
Yesterday the American Hospital Association, four regional hospital associations and four health systems launched a federal court challenge to the controversial two-midnight inpatient admissions policy established by the Centers for Medicare & Medicaid Services.