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Care Delivery

 

The number of counties at risk of having no insurer on their Affordable Care Act (ACA) exchange has fallen to just two, with Centene stepping in to cover potentially bare counties in Nevada.

The idea of a national, single-payer healthcare system is as divisive as ever to people within the industry, according to a new survey from cloud-based researcher company Reaction Data.

When asked to identify what regulations are the most burdensome, physician practices pointed at the Merit-based Incentive Payment System (MIPS) being implemented as part of the Medicare Access and CHIP Reauthorization Act (MACRA).

Insurance giant Anthem continued its departure from Affordable Care Act (ACA) exchanges, announcing it will no longer offer plans in Nevada and 74 counties in Georgia.

CMS has approved a five-year extension of Florida’s statewide Medicaid managed care demonstration, including $1.5 billion in funding for support uncompensated care for low-income patients.

 

Recent Headlines

Hospitals cutting back on blood utilization

There appears to be a direct link between hospitals’ initiatives to improve blood use stewardship and a 20 percent decrease in blood utilization for 134 diagnoses which make up 80 percent of red blood cell usage.

Smaller systems aren’t embracing value-based care

Most healthcare organizations with revenue under $1 billion surveyed by the Ernst & Young LLP Advisory Health practice reported having no value-based reimbursement initiatives and placed a lower priority on bundled payments and alternative payment models than larger systems.

Benefits targeted by ACA repeal bills aren’t biggest drivers of cost

States would be able to waive requirements for insurers to cover the Affordable Care Act (ACA)’s “essential health benefits” (EHBs) under Republican plans to replace the law. The benefits most likely to be waived, however, make up small shares of premiums compared to other costs, according to an analysis from Urban Institute fellows Linda Blumberg, PhD, and John Holahan, PhD.

Value-based care doesn’t have to end independent practices

The transition to value-based care has led to consolidation and increased physician employment, but smaller practices may find a different option in pursuing alignments with other organizations which don’t involve giving up their independent status.

Tufts Medical Center nurses to strike on July 12 over staffing, pension issues

Nurses at Tufts Medical Center in Boston are planning to go on a one-day strike on July 12, while the hospital has hired enough replacement nurses for a five-day lockout.

HFMA 2017: Provider-payor collaboration limited by phone calls, administrative waste

Providers and payors want to work together on transitioning to value-based care. What gets in the way is poor communication and time wasted on redundant administrative tasks, according to a Availity survey released at the Healthcare Financial Management Association (HFMA) conference in Orlando.

Huntsman Cancer Institute opens new research center

The University of Utah’s Huntsman Cancer Institute (HCI) has opened a 225,00-square-foot expansion which it said doubles its laboratory space for cancer research.

Medicaid expansion increased ER visits overall, but lowered them among uninsured

States that expanded Medicaid eligibility saw emergency department (ED) use per 1,000 people increase by 2.5 visits in 2014, with the share of ED visits covered by Medicaid increasing by 8.8 percentage points compared to states that didn’t expand the program under the Affordable Care Act.

How ACOs change their workforces to manage risk

Value-based care models have led accountable care organizations to change how they utilize their workforce through interdisciplinary teams and managing care by focusing on the highest-risk, and highest-cost, patients.

AMA 2017: Injecting health systems science into med school curriculums

Health systems have appeared eager to partner with medical schools on preparing medical school students for the value-based care world in which they’ll be practicing, though some educators are worried about being lost in that transition.

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