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  October 8, 2012 Follow us on FacebookFollow us on TwitterJoin us on LinkedInRSS feed

Why Risk-Based Contracts Are Worthwhile

Karen Minich-Pourshadi

Participation in risk-based contracting by physicians, hospitals, and health systems continues to be slow. While getting payers to agree to a fair margin adds to the complexity of the contracting negotiations, one hospital system CFO says, "there's usually up-side, not down-side risk." >>>

 

Editor's Picks

OIG to Investigate Hospital Payments in 2013

Federal health investigators say they are launching 112 new investigations as part of their 2013 work plan, including 25 projects that examine Centers for Medicare & Medicaid Services payment policies to hospitals. >>>

Recovery Auditor Improper Payments Ratchet Up

The Centers for Medicare & Medicaid Services has once again corrected more improper payments than in the previous quarter, this time to the tune of $701.3 million. >>>

How CBOs May Help Shrink Readmissions

Under a program outlined in the Patient Protection and Affordable Care Act, community-based organizations stand to receive federal funds to do in outpatient settings certain tasks that hospitals don't and can't—to help patients self-manage their care for 30 days post-discharge. >>>

HIEs Essential in Fee-for-Value Era

Though preliminary results indicate health information exchanges can help healthcare organizations save money, there's still reluctance by some to share data. To realize the cost benefits, healthcare leaders must make a clinical and financial leap of faith and work with their competitors. >>>

DRG 312 Reviews Put Providers 'In a Squeeze'

Under diagnosis-related group 312, providers in Ohio and Kentucky could potentially have their records requested by Medicare recovery audit contractors for a complex medical review. The CIGNA Government Services error rate for DRG 312 is 80 percent. >>>

Q&A: Kaiser Permanente CEO Halvorson on Retirement

Kaiser Permanente chairman and CEO George Halvorson discusses his plans to step down in December 2013 from his dual role as chief of the nation's largest nonprofit health plan and head of a health system with 37 hospitals and 600 medical offices. >>>



LIVE Webcast

Webcast: Cardiology Service Line—From Volume to Value

Date: Nov. 27, 2012, 1:00-2:30 p.m. ET Coordinate protocols and standardize approaches to better manage cost and reform transitions in the cardiology service line, without cutting into the service or quality of care. Join Sanger Heart & Vascular Institute, Sacred Heart Hospital, and Wellmont Health System as they share tactical approaches for maneuvering through healthcare reform transitions in the cardiology service line. Register Today >>>



News Headlines

NC Attorney General eyes 'artificial' hospital pricing

The Charlotte Observer, October 8, 2012

6 NY hospitals, in life-or-death fiscal straits, look at collaboration

Watertown Daily Times, October 8, 2012

Insurers balk at covering GYN treatment by OhioHealth

The Columbus Dispatch, October 8, 2012

Highmark plan seen as riskier than ever

Pittsburgh Post-Gazette, October 8, 2012

Medicare errs in hospital readmission penalties

NPR, October 5, 2012

Hospitals need networks to prevent readmissions

Kaiser Health News, October 5, 2012

UnitedHealth, Hartford hospital in contract battle

The Hartford Current, October 5, 2012

Feds charge 91 in massive Medicare fraud scheme

CBS News, October 5, 2012

More MA doctors embracing new payment models

The Boston Globe, October 4, 2012

Electronic medical billing may inflate payments

The Dartmouth, October 4, 2012



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Multimedia/Events

Rounds: Cancer Service Line Leadership—Baylor Health Care System

Date: Nov. 6, 2012, 12:00-3:00 p.m. CT Baylor Health Care leaders reveal how they have built a cutting-edge cancer care model that combines personalized guidance, tailored treatment, and opportunities to participate in clinical trials of new treatments. Get real-world solutions, interactive Q&A, and lessons learned, including how to and combine the best aspects of academic and private practice cancer models to serve patients better. Register Today Download Free Case Study >>>




From HealthLeaders Magazine

Metrics That Matter

Business intelligence and analytics are invaluable tools to power healthcare decision-making. >>>

 

The Promise of mHealth

 

The Business Case for the HIE



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