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Care Delivery

 

The second year of the Merit-based Incentive Payment System (MIPS) has proposed new option for participation, with clinicians able to join together in “virtual groups” to report on MIPS performance measures.

The average millennial—someone born between 1982 and 2000—is nearly twice as likely to become a registered nurse (RN) than a baby boomer, a “surprising surge of interest” potentially averting a large national shortage of nurses.

In 2016, there were more than 200 freestanding emergency departments (EDs) in Texas, the center of a boom in these sites of care. With far fewer restrictions on where they can be built compared to hospital-based EDs, most of these facilities have been built in areas where residents have higher household incomes.

The 626 health systems in the U.S. accounted for the majority of hospitals, beds and discharges in 2016, according to data released by the Agency for Healthcare Research and Quality (AHRQ).

Group market insurance plans had premiums increase by an average of 3 percent this year, the sixth consecutive year of a single-digit hike and well below the 20 percent jump in non-group market premiums, while employers continue to search for ways to cut costs through different sites of care and wellness programs.

 

Recent Headlines

AAMC: Physician shortage could surpass 100,000 by 2030

The Association of American Medical Colleges (AAMC) said the nation’s physician shortage isn’t going to get any better, projecting a shortage of between 40,800 and 104,900 doctors by 2030 in a report conducted by global information company IHS Markit.

First-year residents will once again be able to work 24-hour shifts

The Accreditation Council for Graduate Medical Education (ACGME) has revised its limits on how long first-year residents can work in a single shift, increasing it from 16 to 24 hours, matching the maximum for residents at all levels.

How delivery system innovations can succeed: ‘Do fewer projects, but do them better’

The need for changing healthcare delivery is clear, according to David Bates, MD, MSc, chief of the general internal medicine division at Brigham and Women’s Hospital in Boston. Allowing those changes to succeed in the world of value-based care, however, may require organizations to devote more of its own resources to delivery system reforms. 

HIMSS 2017: Prior authorization flaws require collaborative response

A multi-stakeholder conversation about the burden of prior authorization requirements offered a consensus that something has to change with these policies, but the parties could not offer a silver bullet on how the process can improve.

Telehealth increases utilization instead of replacing office visits

Using direct-to-consumer telehealth, where a patient was direct access to a physician on the phone or through videoconferencing, may be a tool to increase access to care. According to a study published in the March 2017 issue of Health Affairs, it also increases utilization and spending. 

Need for real-world evidence in value-based care could be advantage for pharma

With more physicians employed in larger organizations than private practices, and those larger groups being more likely to be reimbursed through models which involve financial risk, more physicians are looking to real-world evidence to inform their clinical decisions—a shift which could be beneficial for pharmaceutical companies.

New Jersey law limits initial opioid prescriptions to five days

New Jersey has enacted what its governor calls the strictest anti-opioid law in the country, affecting how long the length of initial prescriptions and waiving prior authorization requirements for those seeking treatment for addiction.

Uninsured rate at 8.8 percent; high-deductible plans on the rise

The latest National Health Interview Survey figures on health coverage show the number of people without health insurance fell to a new low through the first nine months of 2016.

California insurers reported inaccurate provider info to regulators

According to a review released by the California Department of Managed Health Care (DMHC), 90 percent of California insurer reports on which providers were in their network contained inaccurate information.

Lower wages change utilization, even in employer-sponsored insurance plans

Workers who make $24,000 or less annually, but still have employer-sponsored health insurance, have higher hospital and emergency department admissions rates and lower utilization of preventive care compared to higher-paid coworkers.

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