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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

New AMA textbook offers clinician perspective on value-based care

The American Medical Association has announced the launch of a new “health sciences” textbook for medical school students, focusing on the transition towards value-based care and the skills physicians will need to navigate this new system, including using electronic health records.

425 physicians pulled from Tufts network

New Bedford, Massachusetts-based Southcoast Health System is forming its own independent doctors group, which means its 425 physicians will be leaving Tufts Medical Center’s network.

Price transparency led patients to choose lower-cost hospitals

When given access to transparency tools estimating prices for imaging services and sleep studies, commercially-insured patients were more likely to choose lower-cost hospitals.

Too few medical school grads choose family medicine

Medical schools are “underproducing” family physicians, according to a new survey, though some states and regions seem to have more success with graduates choosing to go into primary care.

First advanced certification for total hip, knee replacement awarded by Joint Commission

Ohio Specialty Surgical Suites of North Canton has become the first ambulatory surgical center to earn the Joint Commission’s advanced certification for total hip and total knee replacement.

UPMC’s acquisition of Susquehanna Health comes with $500 million in improvements

The four-hospital Susquehanna Health system is officially a part of the University of Pittsburgh Medical Center (UPMC), with the deal including $500 million in renovations and upgrades at the newly acquired facilities.

BCBS of Texas will launch new plan for children with demanding, complex conditions

Blue Cross Blue Shield of Texas will soon offer more benefits to families with children suffering from complex and demanding conditions, such as mental health disease or drug and alcohol addiction.

Weathering the storm: Maintaining imaging in the face of disaster

Hospital administrators and leaders can ensure their imaging services remain operational during a disaster scenario with careful planning and management.

Employer demand for value-based care is growing

More employers are implementing value-based reimbursement and payment arrangements with insurers and providers, according to a survey released by employee benefits consulting firm Willis Towers Watson.

The 5 innovation questions CMS wants exchange insurers to ask themselves

Health insurers need to see the changing healthcare market as an opportunity to innovate like some car companies have done in their industry, CMS Acting Administrator Andy Slavitt said at an Oct. 5 forum of marketplace insurers.

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