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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

Physicians warn Trump immigration order will worsen doctor shortage, affect care

Two University of Pennsylvania Medical Center physicians said suspending immigration from seven Muslim-majority countries will have a negative impact on graduate medical education (GME) and the U.S. healthcare system as a whole.

Major organizations aim to change prior authorization requirements

A coalition of medical organizations led by the American Medical Association has released a 21-point plan to change when health insurers require pre-approval before patients can receive certain treatments, drugs or devices.

Illinois governor proposing new pharmacy rules after risky drug combinations go unnoticed

In response to a Chicago Tribune investigation, Illinois Gov. Bruce Rauner is a backing of series of changes to the state’s oversight of pharmacies, including sending “mystery shoppers” to make sure pharmacists are warning customers when their prescriptions may have adverse effects when taken together. 

Anthem ending opioid treatment preauthorization nationwide

Anthem has reached a settlement with New York Attorney General Eric Schneiderman to end its policy requiring prior authorization for medication-assisted treatment (MAT) for opioid addiction.

CMS: 45% of provider locations in Medicare Advantage directories are inaccurate

A CMS review of provider directories set up by Medicare Advantage plans found many listed the wrong phone numbers or locations for physicians or incorrectly labeled physicians as accepting new patients.

Long-term uninsured made up most of ACA’s initial coverage gains

People who had gone three years or more without having health insurance made up more than half of the gains in coverage in 2014, the first year of the Affordable Care Act (ACA)’s insurance marketplace and Medicaid expansion. 

Half of ICU patients didn’t need intensive care in single-center study

More than half of intensive-care unit (ICU) patients (53 percent) at one large teaching hospital would have received more appropriate care in a different, less intensive setting. 

WellCare acquires Arizona health plans, names new leadership

Medical insurance company WellCare Health Plans has acquired two Arizona health plans and named a new executive to oversee the transition.

Pennsylvania medical college integrates with Geisinger Health System

The new year has brought the final approvals to legally integrate Pennsylvania’s Commonwealth Medical College into Geisinger Health System, creating the new Geisinger Commonwealth School of Medicine.

Healthcare.gov sign-up deadline pushed back

HHS pushed back the deadline for customers to buy coverage on the Affordable Care Act (ACA)'s federally run insurance exchange, giving buyers until Dec. 19 to pick a health plan which will go into effect in the new year.

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