You are here

Care Delivery

 

UnitedHealth Group has announced plans to expand its work with physicians, health systems and CMS in working with bundled payments in fee-for-service Medicare, including the new Bundled Payments for Care Improvement Advanced program.

Trained community or lay health workers (LHW) helped a rural hospital in Kentucky lowered its 30-day readmission rates among a high-risk population by almost 48 percent, according to a study published in Health Education Research.

Anthem has been criticized and even sued over policies in several states where it won’t pay for emergency room visits it later determines to be unnecessary. The insurer has now softened those restrictions, but American College of Emergency Physicians (ACEP) said the changes don’t go far enough.

Purdue Pharma, best known for making and selling OxyContin, announced Feb. 10 that it will stop marketing opioid drugs to physicians. The company also stated it will lay off half of its sales force, with the remaining staff of 200 focusing on other medications.

Medicaid patients face a host of challenges in accessing care, with reliable, timely transportation often being a major consideration. A recently published study, though, showed rates of missed primary care appointments were unaffected when Medicaid patients were offered free ridesharing services.

 

Recent Headlines

What health benefits insurers would most likely eliminate under AHCA

Maternity care services may the first thing insurers on the individual market drop from plans if the American Health Care Act (AHCA) becomes law and states seek waivers on what benefits have to be covered.

ACA enrollment fell by nearly 2M by mid-March

A new report from CMS said that effectuated enrollment in the Affordable Care Act (ACA) exchanges was lower than 1.9 million because of customers not paying their premium—with some blaming the monthly cost has the reason for ending their coverage.

40% of adults enrolled in high-deductible insurance plans

A recent survey shows an increasing number of adults were enrolled in health plans with deductibles above $1,300 for individual plans and $2,600 for family coverage in 2016 as more employers turn to plans with higher out-of-pocket costs.

$155M cancer pavilion expansion begins at Henry Ford Health

Detroit’s Henry Ford Health System has broken ground on a $155 million expansion of its cancer institute, to be named the Brigette Harris Cancer Pavilion.

Med school enrollment up 28% since 2002, but residency slots may not be keeping pace

First-year enrollment at medical schools in the U.S. has gone up by 28 percent since 2002, but schools have told the American Association of Medical Colleges (AAMC) they have concerns there aren’t enough residency slots to match that growth.

MidMichigan Health plans to build $57 million cardiovascular center

MidMichigan Health is hoping to begin a $57 million construction project at its flagship campus in Midland in fall 2017 to build a new heart and vascular center.

CPC+ applications open for second round

Primary care practices in Louisiana, Nebraska, North Dakota and New York’s Erie and Niagara Counties can now apply to participate in the second round of CMS’s Comprehensive Primary Care Plus (CPC+) model.

CMS pushes back cardiac, orthopedic bundles to 2018

For the second time under the Trump administration, CMS has delayed the implementation date of bundled payments for cardiac care and an expansion of a joint replacement model, which are now due to begin Jan. 1, 2018, opening the door to additional changes, like making the models voluntary rather than mandatory.  

Cedars-Sinai, Torrance Memorial propose affiliation

Two large hospitals in the Los Angeles area would be under the same parent organization under a proposed affiliation plan announced by Cedars-Sinai and Torrance Memorial Medical Center.

Geisinger, Highmark pursuing joint venture on new care model

Geisinger Health System and insurer Highmark have signed a letter of intent for a new joint venture to develop a new clinical network and reimbursement in four Pennsylvania counties.

Pages