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  May 2, 2012 Follow us on FacebookFollow us on TwitterJoin us on LinkedInRSS feed

Health Plans Ramp up for Healthcare Reform

Margaret Dick Tocknell

More than 80% of surveyed health plan executives say they are already implementing some type of reform measures or plan to implement them this year. But readiness levels for key provisions of the Affordable Care Act—accountable care organizations and health insurance exchanges—vary considerably. >>>

 

Editor's Picks

CMS Plan Would Tie Efficiency Scores to Hospital Payments

Efficiency scores measure cost per Medicare beneficiary at acute care hospitals and could mean as much as $200,000 for every $1 million of incentive payments in the value-based purchasing pool. But some hospitals say the scores are neither fair nor accurate. >>>

Hospital Readmissions, Mortality Incentives Alarmingly Misaligned

Why does the Affordable Care Act impose much stiffer financial penalties on hospitals with higher 30-day readmission rates than for hospitals with higher 30-day mortality? Isn't preventing death, the ultimate bad outcome, much more important to incentivize? >>>

In Transfusion, More Blood Means More Risk, Higher Cost

Variations in transfusion thresholds mean that many surgeons put patients in harm's way by transfusing more blood than necessary for good outcomes, raising risk and costs, researchers say. >>>

How Predictive Modeling Cuts Readmissions

With the threat of reimbursement losses for preventable 30-day readmissions, healthcare organizations are analyzing care transitions used in tandem with predictive models to keep patients from returning to their facilities unnecessarily. >>>

Medicaid Contractors Struggle to Identify Overpayments

Audit Medicaid Integrity Contractors are having a difficult time identifying overpayments, says a report from the Office of Inspector General. It suggests the problem may be with the data used and analysis conducted to identify audit targets. >>>



NEW LIVE Webcast

Boost Physician Referrals, Build Your Bottom Line

Date: May 15, 2012
About: Successful physician referral programs are strategic, data-driven, and coordinated with an organization’s overall physician engagement plan. Join us for a 90-minute, customized webcast with a new interview-driven format, expanded Q&A, online forum, takeaway presentation, and 60-day post-event on-demand access. >>>



News Headlines

MA payment-reform bill would overhaul how healthcare providers are paid

The Washington Post, May 2, 2012

Humana says US Attorney asked about FL claims

Bloomberg, May 2, 2012

In fight over Obama health law, a front in MN

The New York Times, May 1, 2012

Humana reports 21 percent drop in 1Q profit

Bloomberg BusinessWeek, May 1, 2012

Health insurers' push to diversify raises ethical concerns

The Washington Post, April 30, 2012

Stanford Hospital, Blue Shield cut a 3-year deal on rates

Palo Alto Daily News, April 30, 2012

Americans support Medicare reform, but not on their dime

U.S.News & World Report, April 27, 2012

Obama healthcare reforms lead to $1.3B in insurance rebates

Los Angeles Times, April 27, 2012

WellPoint's 1Q profit falls as costs climb

The Boston Globe, April 26, 2012

Disability insurance causes pain for Medicare

The New York Times, April 26, 2012



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Multimedia/Events

Rounds: Building ACO Foundations—Lessons From Kaiser Permanente's Integrated Delivery Model

Date: May 30, 2012
About: Join HealthLeaders Media and host Kaiser Permanente for a live and simulcast three-hour leadership event on how to use the foundations of team medicine, population health management, and actionable data to create your own vision of integration. Access our FREE event case study now, then register for the exclusive companion event. >>>


From HealthLeaders Magazine

 

Physicians, Hospital Executives Get Collaborative

Relationships between physicians and executive leadership have never been smooth, but they've never been more important. Now legislative and contractual changes are forcing both parties to reconsider how they work together. >>>

 

Pharmaceutical Robotics Require Careful Assessment

 

Hospitals Scrutinize ACOs


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