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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

Where execs, clinicians, payers, purchasers stand on single-payer

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.

MIPS named top regulatory burden for physician practices

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).

ACA participation: Anthem scales back in Nevada, Georgia; Intermountain stays put

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 extends Florida’s managed care demonstration

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.

What declaring a national emergency on opioids could mean for healthcare

The White House commission set up by President Donald Trump to address the nation’s opioid addiction “epidemic” has recommended declaring a national public health emergency, which would impact healthcare providers.

Counties at risk of having no ACA insurers shrinking

On July 26, CMS said 40 counties in the U.S. were projected to have no insurers offering coverage on Affordable Care Act (ACA) exchanges. By July 31, that number had shrunk to 19 after five insurance companies announced plans to participate in parts of Ohio.

Women, DOs make up greater share of physicians

The total number of licensed physicians has increased by 12 percent since 2010, with women and Doctors of Osteopathic Medicine (DOs) making up a greater share of the physician population, according to a report released by the Federation of State Medical Boards (FSMB).

Adventist Health shutters financially troubled Washington hospital

Walla Walla General Hospital in Washington has been closed by owner Adventist Health, citing financial challenges and a failed plan to transfer ownership Providence Health & Services.

Hospitals cutting back on blood utilization

There appears to be a direct link between hospitals’ initiatives to improve blood use stewardship and a 20 percent decrease in blood utilization for 134 diagnoses which make up 80 percent of red blood cell usage.

Smaller systems aren’t embracing value-based care

Most healthcare organizations with revenue under $1 billion surveyed by the Ernst & Young LLP Advisory Health practice reported having no value-based reimbursement initiatives and placed a lower priority on bundled payments and alternative payment models than larger systems.

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