Marketplace

Modern Healthcare Breaking News

Latest Breaking News from Modern Healthcare

Proposed 2015 premiums for individual and small-group health plans on Maryland's insurance exchange range from a decrease of 12.1% to an increase of 30.2%.
Posted: June 7, 2014, 12:15 am
Two California state legislators are calling on Truven Health Analytics, which runs the Top 100 Hospitals recognition program, to rescind the honor from two more hospitals owned by Prime Healthcare Services.
Posted: June 6, 2014, 11:00 pm
A multimillion-dollar electronic health-record system installation is eroding the cash flow, and bond rating, of Rhode Island's largest health system.
Posted: June 6, 2014, 10:45 pm
The CMS is looking for a consultant to review an appeals process it has for nursing homes that have been hit with fines for quality or safety issues.
Posted: June 6, 2014, 10:30 pm
Will employee abuse of the Veterans Affairs Department's VistA electronic health-record system give a boost to the private sector's longstanding drive to replace VistA with a commercial, off-the-shelf EHR system, even though the VistA system was not...
Posted: June 6, 2014, 9:15 pm
The VA is facing a torrent of criticism about long waitlists, off-the-books recordkeeping, doctor shortages, and some patient-safety problems. But one issue that hasn't gotten as much attention is the mismatch of VA facilities to where most veterans...
Posted: June 6, 2014, 8:30 pm
Premiums for 2015 healthcare policies are certain to become political fodder during the looming campaign season. That's in part a reflection of timing. Rates will be filtering out in the months leading up to the November elections and the open...
Posted: June 6, 2014, 7:30 pm
Discussions over taxing cosmetic medical procedures such as Botox injections led to a new law in Colorado that limits the state Department of Revenue's ability to audit personal medical information, and has set in motion a process to further...
Posted: June 6, 2014, 6:15 pm
The patient-centered medical home is the foundation of Arkansas' healthcare system transformation efforts, but practices have had a hard time implementing the practice model, so the state has hired medical home pioneers Community Care of North...
Posted: June 6, 2014, 5:45 pm
Steady hiring in healthcare added 33,600 jobs last month, an increase of 0.2%, as ambulatory-care employment swelled by 23,100, a monthly gain that easily exceeds average monthly job growth for the sector.
Posted: June 6, 2014, 2:15 pm

Kaiser Health News - Marketplace

Marketplace Topic

Huffington Post gathers five reporters who followed the passage and implementation of the health law to share their insights. Meanwhile, the journal Health Affairs examines how accountable care organizations have given little attention to surgery, focusing instead on managing chronic conditions, and a new study looks at premium increases before the health law.
Posted: June 6, 2014, 1:16 pm
The Wall Street Journal reports that the federal health insurance website is slated for an overhaul that will likely result in the scrapping of major parts of it that caused problems during last fall's launch. Its tight timeline is among the issues raising new concern. Meanwhile, news outlets also report on small business exchanges as well as developments regarding state online marketplaces in Connecticut, Kansas, Washington and Colorado.
Posted: June 6, 2014, 1:15 pm
Today's early morning highlights from the major news organizations, including reports about the Senate confirmation of Sylvia Mathews Burwell to be the next secretary of the Department of Health and Human Services.
Posted: June 6, 2014, 11:15 am
Despite its lackluster performance in the first quarter, attributed to government cuts to Medicare Advantage programs and new taxes, the insurer's stock has climbed 28 percent since June 4, 2013, the day before its last dividend increase.
Posted: June 5, 2014, 1:30 pm
Administration officials said that in most cases, those discrepancies will not affect consumers' coverage or the level of subsidies they received. Individuals are being asked to submit additional documentation to ensure they’re getting the correct tax credits. About half of the discrepancies involved the incomes people projected for 2014 versus their past income documented in tax returns and the other half involved citizenship or immigration information.
Posted: June 5, 2014, 1:30 pm
A selection of editorials and opinions on health care from around the country.
Posted: June 5, 2014, 1:25 pm
Today's early morning highlights from the major news organizations, including the latest developments regarding congressional action on the veterans' health care scandal as well as reports about the latest Medicaid enrollment figures in the context of the health law.
Posted: June 5, 2014, 11:24 am
According to the Wall Street Journal, five states -- Maryland, Massachusetts, Minnesota, Nevada and Oregon -- will look to their own funds, remaining federal grants and new federal funding requests to pay these costs. In addition, a new study examines the impact of cost-sharing subsidies. News outlets also report on health exchange developments in Missouri and Minnesota.
Posted: June 4, 2014, 1:56 pm
Lawmakers ponder whether to expand the system or just give veterans more opportunities to opt into private health care at federal expense. Some analysts say, though, that any fixes could be held up in the Senate by election year bickering.
Posted: June 4, 2014, 1:22 pm
A selection of editorials and opinions on health care from around the country.
Posted: June 4, 2014, 1:17 pm
Today's early morning highlights from the major news organizations, including a story about the costs some states will face in attempting to fix their online insurance marketplace.
Posted: June 4, 2014, 11:09 am
The filings in Arizona and Connecticut are shedding light on what insurers might do elsewhere. News outlets also report on developments in Nevada and Maryland related to health exchange costs and coverage issues.
Posted: June 3, 2014, 1:55 pm
A selection of editorials and opinions on health care from around the country.
Posted: June 3, 2014, 1:22 pm
These donor physicians have also become more generous, and the shift of these medical professionals from their historic preference for Republican candidates to their recent affinity for Democrats is attributed to the increase in women doctors and the decline in the number who run their own practice or work in small practices.
Posted: June 3, 2014, 1:20 pm
Humana Inc. alleges the device maker violated federal racketeering statutes by conspiring with prominent physicians to promote unapproved uses of the drug, reports The Wall Street Journal. Meanwhile, Ventas, the nation's biggest health care real estate investment trust, said Monday it had agreed to acquire the American Realty Capital Healthcare Trust for $2.6 billion.
Posted: June 3, 2014, 1:19 pm
Take a look at KHN's lighter side, featuring today's cartoon and health policy haiku.
Posted: June 3, 2014, 1:17 pm

HealthLeadersMedia.com - Finance News & Analysis

HealthLeaders Media is a leading multi-platform media company dedicated to meeting the business information needs of healthcare executives and professionals.

Inpatient care is still a bedrock of almost all health systems, but its role in the care continuum is changing dramatically.

Posted: June 6, 2014, 11:57 am

The Senate confirmed Sylvia Mathews Burwell, the White House's budget director for the past year, on Thursday as the 22nd secretary of the Department of Health and Human Services. On a bipartisan vote of 78 to 17, senators approved Burwell to lead the government's largest domestic department, ending a quick confirmation process that was devoid of the bitter partisanship surrounding the 2010 Affordable Care Act and the changes it is bringing to the U.S. health-care system. Senate Finance Committee Chairman Ron Wyden (D-Ore.), whose committee had recommended Burwell to the full Senate, said that she attracted what he called "a choir of bipartisan support" because "she is really that good, she is really that capable, and she is really that qualified."
Posted: June 6, 2014, 11:38 am

The Obama administration is revamping HealthCare.gov and scrapping significant parts of the federal health-insurance marketplace in an effort to avoid the problems that plagued the site's launch last fall, according to presentations to health insurers and interviews with government officials and contractors. But the makeover—and the tight timeline to accomplish it—are raising concerns that consumers could face another rocky rollout this fall when they return to the site to choose health plans. Some key back-end functions, including a system to automate payments to insurers, are running behind schedule, according to a presentation federal officials made to health insurers. [Subscription Required]

Posted: June 6, 2014, 11:37 am

Congressional budget scorekeepers estimated Thursday that only a fraction of the people without health insurance in 2016 will actually pay a penalty under ObamaCare's individual mandate. In a new analysis, the Congressional Budget Office (CBO) said only 4 million of the 30 million who are expected to be uninsured in 2016 will pay a fine. The number is a lower estimate than in 2012, before the administration added exemptions to the mandate. The CBO previously estimated that 6 million people would pay a fine. All told, the government is projected to collect $4 billion from individual mandate penalties in 2016, followed by $5 billion every year through 2024, according to the CBO.
Posted: June 6, 2014, 11:34 am

The ratio of those without health insurance has fallen dramatically since last year but held steady at a new low of 13.4 percent for May and April, according to a poll. A Gallup survey published Thursday shows the uninsured in the U.S. dropped from 17.4 percent in the last quarter of 2013, when HealthCare.gov launched, to 15.6 percent in the first quarter of this year, before eventually landing at 13.4 percent. "The uninsured rate for U.S. adults appears to be leveling off since the open enrollment period for buying health insurance coverage through the marketplace ended in mid-April," said Gallup. "Across nearly every major subgroup, the uninsured rate is lower now compared with the fourth quarter of 2013."
Posted: June 6, 2014, 11:29 am

Accountable Care Organizations have given little attention to surgery in the early years of the Medicare program, choosing to focus instead on managing chronic conditions and reducing hospital readmissions. That's according to a case study and survey published this week in the journal Health Affairs. The authors conducted case studies at four ACOs in 2012 and sent a survey to all 59 Medicare ACOs in the first year of the program, with 30 responding. "I'm a surgeon, so I was really curious as this model probably continues to gain steam, what's this going to mean for me?" said lead author James M. Dupree, a urologist at Baylor College of Medicine.

Posted: June 6, 2014, 11:26 am

In April 2014, the Centers for Medicare and Medicaid Services (CMS) released data for payments Medicare made to doctors and outpatient providers nationally in 2012. The release touched off a series of discussions that focused on outlier physicians, have led to investigations of care patterns and calls for caution in using such data, all prompting CMS officials to defend their release. It is unclear what the impact of such a release will be, but much of the public doesn't understand that the unprecedented data release excludes the payment data for three in 10 Medicare beneficiaries — those enrolled in Medicare's private insurance option, Medicare Advantage (MA).

Posted: June 6, 2014, 11:23 am

Pregnant? Want to avoid a C-section if at all possible? The state Department of Health Services may be able to help. New data has just been uploaded onto an agency-run website to help would-be patients learn which hospitals have the highest rates of pregnancies ending with surgery. State Health Director Will Humble said that should give patients an idea of where procedures are more likely to short-circuit normal labor and delivery. But that's only the start of it. The site also helps compare, on a hospital-by-hospital basis, outcomes on all sorts of medical issues, like how often a surgery patient bleeds after a procedure to the chances of dying in the hospital after heart failure.
Posted: June 6, 2014, 11:19 am

As the purchaser representative on the federal Health IT Policy Committee, David Lansky, PhD., is the voice of employers, insurers, and other organizations responsible for healthcare compensation. It's a role he's handled for five years, one that complements his full-time position as CEO and president of Pacific Business Group on Health, a nonprofit business coalition that helps its 60 purchaser members provide coverage to more than 3 million employees by improving the quality and affordability of healthcare. In both positions, Lansky focuses on improving the nation's healthcare delivery system by curtailing unnecessary spending and enhancing visibility by measuring outcomes and value.

Posted: June 6, 2014, 11:16 am

As Medicare officials mull new rules and a second round of participant recruitment for the Pioneer ACO program, healthcare providers are quick to point out how the gainsharing model can be improved.

Posted: June 5, 2014, 11:49 am

About 2.2 million people, or more than one in every four Americans who signed up for private health coverage under President Barack Obama's healthcare reform law, have inconsistent data in their applications that could lead to them losing coverage in isolated cases, officials said on Wednesday. Republicans, who have made the law known as Obamacare a top issue for November's midterm congressional elections, pounced on the disclosure as fresh evidence that it poses an unworkable burden for Americans. But officials denied that the data issues rise to the level of problem enrollments, saying consumers in many cases included data on income, citizenship and immigration that is more up to date than federal records show.
Posted: June 5, 2014, 11:39 am

The U.S. Senate on Wednesday cleared the way for lawmakers to decide on Thursday whether to confirm Sylvia Mathews Burwell as President Barack Obama's new health secretary. Senators voted 67-28 to approve a procedural measure limiting debate on Burwell's nomination to no more than 30 hours, allowing a final confirmation vote to move forward sometime on Thursday. Senate approval is widely expected. A confirmation vote allowing Burwell to take over implementation of Obamacare from departing U.S. Health and Human Services Secretary Kathleen Sebelius could help open a new chapter for Obama's healthcare law just five months before November's midterm congressional elections.

Posted: June 5, 2014, 11:36 am

Congressional budget scorekeepers said they can no longer measure the fiscal impact of many provisions of ObamaCare because the task is impossible. In a little-noticed footnote from April, the Congressional Budget Office (CBO) said it will continue to assess the effects of the law's exchange subsidies and the Medicaid expansion, while not tracking others. "The provisions that expand insurance coverage established entirely new programs or components of programs that can be isolated and reassessed," the office wrote. "In contrast, other provisions of the Affordable Care Act significantly modified existing federal programs and made changes to the Internal Revenue Code.
Posted: June 5, 2014, 11:34 am

Individual health insurance premiums in the years before President Barack Obama signed the Affordable Care Act into law had large average increases and a high variability in rate hikes across different states and insurers, a study released Thursday found. Nonpartisan foundation The Commonwealth Fund said its findings provide the most comprehensive data assembled to date for use as a benchmark comparison with Affordable Care Act-era price increases, which have begun being released for the 2015 plan year. The study, which examined the years 2008 to 2010, found that health insurance premiums for people buying coverage on their own—not as part of an employer-provided plan—grew more than 10 percent on average.

Posted: June 5, 2014, 11:33 am

UnitedHealth is once again hiking the quarterly dividend it gives shareholders by more than 30 percent, with the latest increase tripling the initial value of a payout the nation's largest health insurer debuted in 2010. The insurer said Wednesday it will pay a cash dividend of 37.5 cents per share on June 25 to stockholders of record as of June 16. That's up nearly 10 cents from the Minnetonka, Minnesota, company's current payout of 28 cents per share. UnitedHealth Group Inc. became the first health insurer to offer more than a token payout to shareholders in 2010 when it started providing a quarterly dividend of 12.5 cents per share.

Posted: June 5, 2014, 11:31 am

On Wednesday, the Florida Supreme Court questioned lawyers in a continuing dispute over a 2003 medical-malpractice law limiting the amount of money a woman can receive because of complications after leg surgery. The case centers on if damage caps set by lawmakers can apply to the case of Kimberly Ann Miles, a Miami-Dade County woman who was injured prior to the passage of the 2003 law, but filed a lawsuit in January 2006. Miles and her husband received a jury award of $1.5 million in non-economic damages, which was subsequently reduced to $500,000 due to the law.
Posted: June 5, 2014, 11:27 am

Removing the consumer pinch from narrow provider networks in individual insurance exchanges is a matter of striking a "delicate balance" between payers and the insured, suggests a Robert Wood Johnson Foundation report.

Posted: June 4, 2014, 11:57 am

The federal government wrongfully paid Medicare Advantage programs almost $70 billion, mostly through overbilling between 2008 and 2013, according to a new report. The Center for Public Integrity released the first of its four part investigative series Wednesday on Medicare Advantage payments that examines the use of risk scores used by providers to charge the government more for sicker patients. CPI found between 2007 and 2011, scores for Medicare Advantage patients grew twice as fast when compared to ordinary Medicare patients in more than 500 counties. The report cites government audits of six Medicare Advantage plans in 2007 alone with nearly $650 million in overpayments.
Posted: June 4, 2014, 11:39 am

The Department of Health and Human Services is offering $300 million to help community health centers treat newly insured patients under the Affordable Care Act. The money will be used to expand service hours, hire more healthcare providers, and add oral health, behavioral health, pharmacy, and vision services according to HHS. HHS Secretary Kathleen Sebelius said community health centers have helped more than 4.7 million people enroll in ObamaCare since last fall. "Health centers are key to the Affordable Care Act's goal of expanding access to health care," said Sebelius. "They are critical providers of care and have also been instrumental in linking people to coverage through the Health Insurance Marketplace."
Posted: June 4, 2014, 11:34 am

While provider organizations continue the spending frenzy on their health information technology capabilities, not all are pleased with their purchases.

Posted: June 2, 2014, 5:14 pm

HealthLeadersMedia.com - Finance News & Analysis

HealthLeaders Media is a leading multi-platform media company dedicated to meeting the business information needs of healthcare executives and professionals.

Inpatient care is still a bedrock of almost all health systems, but its role in the care continuum is changing dramatically.

Posted: June 6, 2014, 11:57 am

The Senate confirmed Sylvia Mathews Burwell, the White House's budget director for the past year, on Thursday as the 22nd secretary of the Department of Health and Human Services. On a bipartisan vote of 78 to 17, senators approved Burwell to lead the government's largest domestic department, ending a quick confirmation process that was devoid of the bitter partisanship surrounding the 2010 Affordable Care Act and the changes it is bringing to the U.S. health-care system. Senate Finance Committee Chairman Ron Wyden (D-Ore.), whose committee had recommended Burwell to the full Senate, said that she attracted what he called "a choir of bipartisan support" because "she is really that good, she is really that capable, and she is really that qualified."
Posted: June 6, 2014, 11:38 am

The Obama administration is revamping HealthCare.gov and scrapping significant parts of the federal health-insurance marketplace in an effort to avoid the problems that plagued the site's launch last fall, according to presentations to health insurers and interviews with government officials and contractors. But the makeover—and the tight timeline to accomplish it—are raising concerns that consumers could face another rocky rollout this fall when they return to the site to choose health plans. Some key back-end functions, including a system to automate payments to insurers, are running behind schedule, according to a presentation federal officials made to health insurers. [Subscription Required]

Posted: June 6, 2014, 11:37 am

Congressional budget scorekeepers estimated Thursday that only a fraction of the people without health insurance in 2016 will actually pay a penalty under ObamaCare's individual mandate. In a new analysis, the Congressional Budget Office (CBO) said only 4 million of the 30 million who are expected to be uninsured in 2016 will pay a fine. The number is a lower estimate than in 2012, before the administration added exemptions to the mandate. The CBO previously estimated that 6 million people would pay a fine. All told, the government is projected to collect $4 billion from individual mandate penalties in 2016, followed by $5 billion every year through 2024, according to the CBO.
Posted: June 6, 2014, 11:34 am

The ratio of those without health insurance has fallen dramatically since last year but held steady at a new low of 13.4 percent for May and April, according to a poll. A Gallup survey published Thursday shows the uninsured in the U.S. dropped from 17.4 percent in the last quarter of 2013, when HealthCare.gov launched, to 15.6 percent in the first quarter of this year, before eventually landing at 13.4 percent. "The uninsured rate for U.S. adults appears to be leveling off since the open enrollment period for buying health insurance coverage through the marketplace ended in mid-April," said Gallup. "Across nearly every major subgroup, the uninsured rate is lower now compared with the fourth quarter of 2013."
Posted: June 6, 2014, 11:29 am

Accountable Care Organizations have given little attention to surgery in the early years of the Medicare program, choosing to focus instead on managing chronic conditions and reducing hospital readmissions. That's according to a case study and survey published this week in the journal Health Affairs. The authors conducted case studies at four ACOs in 2012 and sent a survey to all 59 Medicare ACOs in the first year of the program, with 30 responding. "I'm a surgeon, so I was really curious as this model probably continues to gain steam, what's this going to mean for me?" said lead author James M. Dupree, a urologist at Baylor College of Medicine.

Posted: June 6, 2014, 11:26 am

In April 2014, the Centers for Medicare and Medicaid Services (CMS) released data for payments Medicare made to doctors and outpatient providers nationally in 2012. The release touched off a series of discussions that focused on outlier physicians, have led to investigations of care patterns and calls for caution in using such data, all prompting CMS officials to defend their release. It is unclear what the impact of such a release will be, but much of the public doesn't understand that the unprecedented data release excludes the payment data for three in 10 Medicare beneficiaries — those enrolled in Medicare's private insurance option, Medicare Advantage (MA).

Posted: June 6, 2014, 11:23 am

Pregnant? Want to avoid a C-section if at all possible? The state Department of Health Services may be able to help. New data has just been uploaded onto an agency-run website to help would-be patients learn which hospitals have the highest rates of pregnancies ending with surgery. State Health Director Will Humble said that should give patients an idea of where procedures are more likely to short-circuit normal labor and delivery. But that's only the start of it. The site also helps compare, on a hospital-by-hospital basis, outcomes on all sorts of medical issues, like how often a surgery patient bleeds after a procedure to the chances of dying in the hospital after heart failure.
Posted: June 6, 2014, 11:19 am

As the purchaser representative on the federal Health IT Policy Committee, David Lansky, PhD., is the voice of employers, insurers, and other organizations responsible for healthcare compensation. It's a role he's handled for five years, one that complements his full-time position as CEO and president of Pacific Business Group on Health, a nonprofit business coalition that helps its 60 purchaser members provide coverage to more than 3 million employees by improving the quality and affordability of healthcare. In both positions, Lansky focuses on improving the nation's healthcare delivery system by curtailing unnecessary spending and enhancing visibility by measuring outcomes and value.

Posted: June 6, 2014, 11:16 am

As Medicare officials mull new rules and a second round of participant recruitment for the Pioneer ACO program, healthcare providers are quick to point out how the gainsharing model can be improved.

Posted: June 5, 2014, 11:49 am

About 2.2 million people, or more than one in every four Americans who signed up for private health coverage under President Barack Obama's healthcare reform law, have inconsistent data in their applications that could lead to them losing coverage in isolated cases, officials said on Wednesday. Republicans, who have made the law known as Obamacare a top issue for November's midterm congressional elections, pounced on the disclosure as fresh evidence that it poses an unworkable burden for Americans. But officials denied that the data issues rise to the level of problem enrollments, saying consumers in many cases included data on income, citizenship and immigration that is more up to date than federal records show.
Posted: June 5, 2014, 11:39 am

The U.S. Senate on Wednesday cleared the way for lawmakers to decide on Thursday whether to confirm Sylvia Mathews Burwell as President Barack Obama's new health secretary. Senators voted 67-28 to approve a procedural measure limiting debate on Burwell's nomination to no more than 30 hours, allowing a final confirmation vote to move forward sometime on Thursday. Senate approval is widely expected. A confirmation vote allowing Burwell to take over implementation of Obamacare from departing U.S. Health and Human Services Secretary Kathleen Sebelius could help open a new chapter for Obama's healthcare law just five months before November's midterm congressional elections.

Posted: June 5, 2014, 11:36 am

Congressional budget scorekeepers said they can no longer measure the fiscal impact of many provisions of ObamaCare because the task is impossible. In a little-noticed footnote from April, the Congressional Budget Office (CBO) said it will continue to assess the effects of the law's exchange subsidies and the Medicaid expansion, while not tracking others. "The provisions that expand insurance coverage established entirely new programs or components of programs that can be isolated and reassessed," the office wrote. "In contrast, other provisions of the Affordable Care Act significantly modified existing federal programs and made changes to the Internal Revenue Code.
Posted: June 5, 2014, 11:34 am

Individual health insurance premiums in the years before President Barack Obama signed the Affordable Care Act into law had large average increases and a high variability in rate hikes across different states and insurers, a study released Thursday found. Nonpartisan foundation The Commonwealth Fund said its findings provide the most comprehensive data assembled to date for use as a benchmark comparison with Affordable Care Act-era price increases, which have begun being released for the 2015 plan year. The study, which examined the years 2008 to 2010, found that health insurance premiums for people buying coverage on their own—not as part of an employer-provided plan—grew more than 10 percent on average.

Posted: June 5, 2014, 11:33 am

UnitedHealth is once again hiking the quarterly dividend it gives shareholders by more than 30 percent, with the latest increase tripling the initial value of a payout the nation's largest health insurer debuted in 2010. The insurer said Wednesday it will pay a cash dividend of 37.5 cents per share on June 25 to stockholders of record as of June 16. That's up nearly 10 cents from the Minnetonka, Minnesota, company's current payout of 28 cents per share. UnitedHealth Group Inc. became the first health insurer to offer more than a token payout to shareholders in 2010 when it started providing a quarterly dividend of 12.5 cents per share.

Posted: June 5, 2014, 11:31 am

On Wednesday, the Florida Supreme Court questioned lawyers in a continuing dispute over a 2003 medical-malpractice law limiting the amount of money a woman can receive because of complications after leg surgery. The case centers on if damage caps set by lawmakers can apply to the case of Kimberly Ann Miles, a Miami-Dade County woman who was injured prior to the passage of the 2003 law, but filed a lawsuit in January 2006. Miles and her husband received a jury award of $1.5 million in non-economic damages, which was subsequently reduced to $500,000 due to the law.
Posted: June 5, 2014, 11:27 am

Removing the consumer pinch from narrow provider networks in individual insurance exchanges is a matter of striking a "delicate balance" between payers and the insured, suggests a Robert Wood Johnson Foundation report.

Posted: June 4, 2014, 11:57 am

The federal government wrongfully paid Medicare Advantage programs almost $70 billion, mostly through overbilling between 2008 and 2013, according to a new report. The Center for Public Integrity released the first of its four part investigative series Wednesday on Medicare Advantage payments that examines the use of risk scores used by providers to charge the government more for sicker patients. CPI found between 2007 and 2011, scores for Medicare Advantage patients grew twice as fast when compared to ordinary Medicare patients in more than 500 counties. The report cites government audits of six Medicare Advantage plans in 2007 alone with nearly $650 million in overpayments.
Posted: June 4, 2014, 11:39 am

The Department of Health and Human Services is offering $300 million to help community health centers treat newly insured patients under the Affordable Care Act. The money will be used to expand service hours, hire more healthcare providers, and add oral health, behavioral health, pharmacy, and vision services according to HHS. HHS Secretary Kathleen Sebelius said community health centers have helped more than 4.7 million people enroll in ObamaCare since last fall. "Health centers are key to the Affordable Care Act's goal of expanding access to health care," said Sebelius. "They are critical providers of care and have also been instrumental in linking people to coverage through the Health Insurance Marketplace."
Posted: June 4, 2014, 11:34 am

While provider organizations continue the spending frenzy on their health information technology capabilities, not all are pleased with their purchases.

Posted: June 2, 2014, 5:14 pm