Healthcare Newsmakers from Modern Healthcare
The people making healthcare business news headlines
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So far largely unseen and unfelt, the effects of making provider pricing data public are about to impact hospitals and health systems in a big way. I'm not going to lie to you—it's going to hurt.
Inpatient care is still a bedrock of almost all health systems, but its role in the care continuum is changing dramatically.
Paul Haidet, MD, applies lessons gleaned from his lifelong love of jazz to teach physicians how to better communicate with patients.
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]
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.
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).
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.
Researchers investigating outcomes at accredited and non-accredited cancer hospitals arrive at "murky" conclusions, which may indicate problems with the way the quality of care is measured.
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.
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.
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.
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.
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.
New models of collaboration (even among competitors) are producing shorter boarding times and fewer instances of aggressive behavior in the emergency department.