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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

Freestanding ERs clustered in wealthier areas

In 2016, there were more than 200 freestanding emergency departments (EDs) in Texas, the center of a boom in these sites of care. With far fewer restrictions on where they can be built compared to hospital-based EDs, most of these facilities have been built in areas where residents have higher household incomes.

AHRQ: Nearly 70% of hospitals are in health systems

The 626 health systems in the U.S. accounted for the majority of hospitals, beds and discharges in 2016, according to data released by the Agency for Healthcare Research and Quality (AHRQ).

Wellness programs, new sites of care common among larger employers’ insurance plans

Group market insurance plans had premiums increase by an average of 3 percent this year, the sixth consecutive year of a single-digit hike and well below the 20 percent jump in non-group market premiums, while employers continue to search for ways to cut costs through different sites of care and wellness programs.

Anthem will re-enter Virginia ACA markets, covering 63 bare counties

Just a month earlier, Anthem had announced it wouldn’t offer ACA exchange coverage in the state, blaming “continued uncertainty” surrounding the law.

ACA’s ‘bare’ county problem is back

Sixty-three cities and counties and more than 70,000 enrollees in Virginia are now at risk of having no insurer participating in their Affordable Care Act (ACA) exchange for 2018, a problem which had appeared to be solved in other parts of the country just two weeks prior.

Construction begins on $270M Texas Health, UT Southwestern campus

Ground has been broken on a $270 million medical campus in Frisco, Texas, that will be jointly operated by Texas Health Resources and the University of Texas Southwestern Medical Center.

Uninsured rate rising in states that didn't expand Medicaid

In the first three months of this year, 8.8 percent of the U.S. population lacked health insurance, a slight decrease from the final 2016 numbers as the big gains in coverage from the Affordable Care Act appear to have ended.

All of US now has at least 1 ACA insurer for 2018

The last county at risk of having no insurers offering plans on the Affordable Care Act (ACA) exchange now has coverage, with CareSource stepping in to sell plans in Paulding County, Ohio.

For those about to operate: Rock music preferred in OR

Surgeons prefer listening to rock music while operating more than any other genre, narrowly beating out pop and classical in a survey of surgeons’ listening habits conducted by Spotify and healthcare app Figure 1.

Centene will offer ACA coverage in bare Nevada counties

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.

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