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Care Delivery

 

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.

Some 11.8 million people signed up for coverage through the Affordable Care Act (ACA)’s insurance exchanges for 2018, down from 12.2 million the year before. Considering changes that were expected to depress enrollment—like HHS shortening the open enrollment period for Healthcare.gov and cutting its advertising budget by 90 percent—signups “remained generally stable,” according to a report from the National Academy for State Health Policy (NASHP).

In 2011, as outlined in the Affordable Care Act (ACA), Medicare began offering wellness visits at no cost to fee-for-service beneficiaries. The goal of the annual checkup was to introduce preventative care and address specific risks such as depression and risk of falling.

 

Recent Headlines

For patients, structural integration doesn’t always mean integrated care

Structurally integrating a medical group may not mean patients see the care its delivering as integrated, according to a study published in the May 2017 issue of Health Affairs.

First physician license approved under interstate compact

Two years after the first states passed legislation adopting the Interstate Medical Licensure Compact (ILMC), the first license has allowing a physician to practice across state lines has been approved.

Children’s healthcare rankings: Vermont named No. 1, Nevada last among states

Judging by 28 different metrics, Vermont offers the highest-quality and most cost-efficient care for children, according to a new study from personal finance website WalletHub, while Nevada struggles with limited access to care and poor oral health among those under the age of 18. 

ACO success limited by high turnover among physicians, patients

The effectiveness of accountable care organizations (ACOs) may be limited by two factors, according to a new study published in Health Affairs: low numbers of enrollees attributed to participating physicians and the constant “churn” of the patient population caused by substantial physician turnover.

Michigan ER doc charged with performing genital mutilation on 7-year-olds

An emergency physician from Michigan has been arrested on charges she performed genital mutilation procedures on multiple girls between the ages of 6 and 8, which prosecutors say could be the first criminal case involving the practice since it was outlawed in the U.S. in 1996.

What U.S. hospitals can learn from a value-based strategy in the Netherlands

While healthcare costs continued to rise at other facilities, one Netherlands hospital was able to lower costs by 8 percent in a single year while improving quality. The credit goes to a value-based care strategy focusing on everything from closer coordination on cardiovascular patients to keeping more experienced physicians in the emergency department. 

ACHE 2017: Embracing value-based care essential to attracting big purchasers like Boeing, Walgreens

Large corporations want healthy workers and lower healthcare costs. If hospitals and medical groups are going to win the right to provide care to those employees and their families, innovative approaches to care, having the right infrastructure in place and taking a lot of meetings are a must. 

AMA: 90% of physicians satisfied with career choice

Despite changes in the healthcare field and multiple surveys finding an increase in physician burnout, almost all doctors say they’re satisfied with their choice to become physicians, according to a new survey from the American Medical Association (AMA). 

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.

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