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Care Delivery

 

In 2014, Maryland adopted an all-payer, global budget program for most of its hospitals, making a fixed payment to facilities for services provided in inpatient, outpatient and emergency departments. In its first two years, the concept contained costs, but didn’t appear to change utilization by patients.

Seventeen more accountable care organizations (ACOs) have joined CMS’s Next Generation ACO model, the most advanced and high-risk available to ACOs in Medicare.

Intermountain Healthcare, Ascension Health, SSM Health and Trinity Health announced they’ll create their own not-for-profit generic drug company, called Project RX, with the goal of increasing pharmaceutical competition and making “essential generic medications more available and more affordable.”

Older diabetic patients are living longer as they and their physicians get better at managing the condition, but with longer lifespans comes additional years of incurring higher healthcare expenditures than non-diabetics.

The number of Americans without health insurance saw its biggest increase in nine years in 2017, rising 1.3 percentage points from the year prior, representing an estimated 3.2 million more people being uninsured.

 

Recent Headlines

What’s a hospital without patients? A St. Louis facility is finding out

The buzzwords related to information technology and advanced communication are familiar—digital, virtual, real-time, eHealth, telemedicine. But sometimes they can be used in a way that’s a bit confusing. For example, a facility outside St. Louis is perhaps the world’s most advanced virtual hospital. But the building is real, the doctors are real, the nurses making rounds are real. It’s just the patients that are missing.

More states join AMA diabetes prevention program

The American Medical Association (AMA) announced it will expand its effort to prevent Type 2 diabetes to eight additional states after it was launched last year in California, Michigan and South Carolina.

Houston hospital closing after hurricane damage

East Houston Regional Medical Center will permanently close after the facility was flooded with six feet of water in flooding when Hurricane Harvey struck the area in August.

ACA enrollment surges in first few days

The first few days of open enrollment on the Affordable Care Act’s exchanges saw more than 600,000 people sign up for coverage, up 79 percent from last year and setting a new record start for enrollment on Healthcare.gov.

20% of doctors want to reduce clinical hours

The prevalence of physician burnout could worsen the shortage of doctors in the U.S., according to an American Medical Association (AMA) survey which found nearly one out of five physicians want to cut back their clinical hours to part-time within a year, while others are thinking of retirement, pursuing a different kind of practice or leaving healthcare altogether.

CMS approves Medicaid waivers for opioid treatment in 2 states

Utah and New Jersey are the first states approved by CMS to design demonstration projects allowing Medicaid to pay for opioid addiction treatment, including enrollees residing in residential treatment facilities.

AMA: 83% of doctors see Medicaid patients

The Affordable Care Act (ACA) did change physicians' total patient mix by health insurance status, with the percentage of uninsured patients shrinking and the average Medicaid patient load increasing in states that expanded eligibility.

States looking beyond managed care to value-based models in Medicaid

State spending on Medicaid grew 3.9 percent while enrollment was up by 2.7 percent in fiscal year 2017, both well below the double-digit increases seen in the years immediately following the expansion of Medicaid eligibility under the Affordable Care Act ACA).

Come together: 5 things to know about forming a virtual group in MIPS

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.

Millennials will dominate nursing profession by 2020

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.

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