Bulletin Board
Bulletin Board
Groups Work to Create New Codes for Social Determinants
Social determinants of health could have their own ICD-10 codes if a new initiative from the American Medical Association and United Healthcare succeeds. The two are working together to develop new ICD-10 codes that would take into consideration social determinants of health such as housing and food security, access to transportation, and ability to pay for medicine. The project launches at a time when research suggests that social determinants of health can affect nearly 80 percent of health care outcomes. Learn more in the Health Analytics IT article “AMA, UnitedHealth [...]
New Web Site Shows Maximum 340B Prices
Providers can now see the maximum prices for 340B-covered drugs on a new web site established by the federal Health Resources & Services Administration. The web site, mandated by Congress after the U.S. Department of Health and Services’ Inspector General found that some providers are being overcharged, will enable 340B-eligible providers to identify the maximum price they can be charged for covered drugs. This, HRSA believes, will help providers avoid being overcharged in the future. Learn more in the Becker’s Hospital Review article “HRSA launches 340B ceiling price website” and [...]
Medicare Advantage Networks Not Narrowing
The primary care networks offered by Medicare Advantage plans are broadening and not narrowing, as some people have long feared. According to a study published in the journal Health Affairs, only 1.8 percent of Medicare Advantage plans offer narrow primary care provider networks, down from 2.7 percent in 2011. Meanwhile, the proportion of plans offering broad networks has grown from 80.1 percent in 2011 to 82.5 percent in 2015. In 2015, broad network plans enrolled 63.9 percent of Medicare Advantage participants, up from 54.1 percent in 2011. This is considered [...]
Moody’s: Challenging Times Ahead for Academic Medical Centers
Academic medical centers will struggle in the near future, according to Moody’s Investor Services. While academic medical centers still have a number of strengths – offering higher-end services, high demand for their inpatient services, and generally strong cash flow margins – they also face a number of challenges that make life more difficult for them in a value-based payment world. Among those challenges, most notably, are higher costs associated with teaching and research, higher-acuity patients, and payment pressure from insurers. Another challenge: the shrinking gap between academic medical center hospitals [...]
Pressure Off 340B?
Two key House subcommittees will not hold hearings on the controversial 340B prescription drug discount program in the near future. The chairs of the House Energy and Commerce Committee’s Oversight and Investigations Subcommittee and its Health Committee have both suggested that House Democrats understand the importance and value of the 340B program and see other health care issues as greater priorities. This marks a serious departure from the last session of Congress, which saw a number of hearings on the 340B program and doubts cast about the program’s objectives and [...]