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North Carolina Proposal Could be Precedent-Setting

Under a new proposal by North Carolina’s state treasurer, health care for state employees could be reimbursed based on a percentage of Medicare rates. North Carolina’s State Health Plan insures more than 700,000 state employees and public school teachers, and under the proposal, doctors, hospitals, and other providers that participate in the plan would agree to accept an as-yet unstated percentage of Medicare rates.  The state treasurer estimates that this approach would save the State Health Plan $300 million a year and save plan participants another $60 million a year. According to North Carolina Health News, the state’s hospitals are [...]

2018-11-09T06:00:39-05:00November 9, 2018|Uncategorized|

Ways and Means Releases Red Tape Report

The House Ways and Means Committee has released a report detailing its efforts to date to reduce red tape in the delivery of health care and to present steps it might take in the future to continue with that process. In the first stage of its red tape project, Ways and Means solicited stakeholder input and heard from nearly 300 stakeholder groups.  Next, it hosted roundtable discussions with various groups to review the issues they raised.  Now, following publication of its report, the committee plans to work in consultation with the administration to advance legislation to address some of the [...]

2018-09-05T06:00:30-04:00September 5, 2018|Uncategorized|

Growing Number of Hospitals on the Critical List

Eight percent of American hospitals – 450 of them – are at risk of closing in the coming years and another 10 percent, or 600 hospitals, are considered “weak” according to a new analysis performed by Morgan Stanley.  The signs of these problems include sinking margins, declining occupancy and revenue, and government and insurer policies that enable patients to receive certain services at facilities other than hospitals, as they did in the past. The largest concentrations of at-risk hospitals can be found in Texas, Oklahoma, Louisiana, Kansas, Tennessee, and Pennsylvania. Learn more about the Morgan Stanley analysis in this Bloomberg [...]

2018-08-29T06:00:43-04:00August 29, 2018|Uncategorized|

Supreme Court Nominee’s Health Care Views

How has Supreme Court nominee Brett Kavanaugh ruled in health care cases that have come before him? In a new review, the Commonwealth Fund examines Judge Kavanaugh’s past opinions on cases involving the Affordable Care Act, abortion and contraception, and Medicare entitlement. It also examines how Judge Kavanaugh approaches adjudicating the cases that come before him and his views on precedent, procedure, and executive and judicial authority. Learn more about the man who could soon join the Supreme Court in the Commonwealth Fund article “Examining Supreme Court Nominee Kavanaugh’s Health Care Opinions.”

2018-07-30T06:00:00-04:00July 30, 2018|Uncategorized|

New Policy Threatens Provider Payments in Missouri

Health care providers that fail to join the provider networks of Missouri Medicaid managed care plans will see their Medicaid payments cut 10 percent by the state under a new state policy. The purpose of the policy, according to the state, is to encourage hospitals and physicians to join the provider networks of three managed care plans that serve more than 700,000 residents of the state.  Providers, on the other hand, say this policy will discourage them from serving Medicaid patients at all and will detract from their ability to negotiate reasonable rates with the state’s three Medicaid managed care [...]

2018-07-11T06:00:15-04:00July 11, 2018|Uncategorized|

Review: Telehealth Shows Mixed Results

A federal review of the use of telehealth services suggests that such services may be appear useful in helping to improve care and reduce costs under certain conditions but are less useful in others. According to a draft currently under review by the Agency for Health Care Research and Quality, Remote intensive care unit (ICU) consultations likely reduce ICU mortality and ICU length of stay (LOS); specialty telehealth consultations likely reduce the time patients spend in the emergency department; and remote consultations for outpatient care likely improve access and a range of clinical outcomes (moderate strength of evidence in favor [...]

2018-06-06T06:00:29-04:00June 6, 2018|Uncategorized|

CMS Unveils Rural Health Strategy

The Centers for Medicare & Medicaid Services had introduced what it calls its “first rural health strategy.” According to the agency, the purpose of the strategy is …to provide a proactive approach on healthcare issues to ensure that the nearly one in five individuals who live in rural America have access to high quality, affordable healthcare. “For the first time, CMS is organizing and focusing our efforts to apply a rural lens to the vision and work of the agency,” said CMS Administrator Seema Verma. “The Rural Health Strategy supports CMS’ goal of putting patients first. Through its implementation and [...]

2018-05-10T06:00:28-04:00May 10, 2018|Uncategorized|

Short-Term Plans May Short-Change Purchasers

The short-term health insurance plans that the administration proposes making more available to consumers as an alternative to comprehensive health insurance that meets Affordable Care Act coverage requirements may leave consumers with greater out-of-pocket costs and less coverage for some critical services. According to a Kaiser Family Foundation review of available short-term, limited duration plans in 10 markets across the country, those plans: often do not cover mental health and substance abuse services and outpatient prescription drugs may turn down individuals or charge them higher premiums based on age, gender, or health status, including pre-existing conditions require greater cost-sharing by [...]

2018-04-25T06:00:12-04:00April 25, 2018|Uncategorized|

Eat! You’ll Feel Better

And maybe need to spend less on health care. That is the lesson learned from a program in Massachusetts that provided home delivery of food to dually eligible Medicare/Medicaid recipients who were struggling with their meals. In a limited experiment, selected individuals received home delivery of food:  some received general meal deliveries while others received food tailored to their individual medical conditions.  The purpose:  address a major social determinant of health in this difficult-to-serve population. The result, according to a report published in the journal Health Affairs, was that Participants in the medically tailored meal program also had fewer inpatient [...]

2018-04-04T06:00:52-04:00April 4, 2018|Uncategorized|

Tackling Social Determinants of Health

The growing awareness of the impact of social determinants of health comes at a time when health care providers are assuming unprecedented degrees of risk for the health of their patients, leaving many providers wondering how best to invest resources that will meet both their own needs as well as the needs of their high-cost, high-need patients. A new document from the Commonwealth Fund, “Investing in social services as a core strategy for healthcare organizations:  Developing the business case,” seeks to serve as a manual for providers seeking to move into this relatively new territory. The report takes providers through [...]

2018-03-28T13:48:33-04:00March 28, 2018|Uncategorized|
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