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  October 9, 2013 Follow us on FacebookFollow us on TwitterJoin us on LinkedInRSS feed

WellPoint Exec Shares Lessons Learned from PCPC Pilot

Margaret Dick Tocknell

Patient-centered primary care is one part of WellPoint's strategy to shift provider reimbursements from volume-based to value-based care arrangements. A year into a multi-state rollout, the program is delivering as expected. >>>

 

Editor's Picks

MGMA Fears 'Catastrophic Backlogs' From ICD-10 Testing Pullback

MGMA is "extremely concerned" that Medicare has announced it will not be conducting ICD-10 end-to-end testing with external trading partners, including physician practices, says the group's  CEO. >>>

Medicare Sees 33% Spike in Claims Appeals

Medicare Part A and Part B appeals rose markedly between 2008 and 2012 with most of the increase coming from appeals of inpatient hospital claims. "We think that the recovery audit contractors are driving a lot of the increase," says an OIG official. >>>

Readmissions 'Drop Like a Rock' with Predictive Modeling

Predictive modeling offers the key to understanding which healthcare services most affect utilization, readmissions, and payment, and how to tackle the outliers. These analytics are within the grasp of any healthcare system. >>>

Toxic Hospital Practices May Fuel Readmissions

In the process of giving life-saving therapies, healthcare providers are often unaware that the dehydration, malnutrition, deconditioning, and information overload that happen during hospital stays may have long-term consequences to the cognitive function of vulnerable patients. >>>

Shorter Wait for Surgery After Stents OK, Surgeon Says

Requiring patients with drug-eluting stents to wait a year before they can undergo elective surgery "is a common problem" for surgeons. But a large-scale study indicates the risk of adverse events such as serious blood clots may be overblown. >>>

Simple Outpatient Protocols Reduce CLABSI by 48%

Training young cancer patients and their families basic methods of preventing central line-associated bloodstream infections could have implications beyond pediatric oncology, since healthcare is increasingly delivered in outpatient settings. >>>



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News Headlines

Insurers getting faulty data from HIX

Insurance Networking News / Bloomberg, October 9, 2013

Questionable design blamed for HIX website woes

Statesman.com / Associated Press, October 9, 2013

U of Miami Hospital overbilled Medicare $3.7M, audit says

The Miami Herald, October 9, 2013

Central Maine Medical Center lauds ruling against Anthem

Portland Press Herald, October 9, 2013

Hospitals and insurers struggle to reduce costs from "super-utilizers"

The Washington Post, October 8, 2013

What everyone is getting wrong about Healthcare.gov

The Washington Post, October 8, 2013

America's healthcare upheaval: Will it get better?

The Economist, October 8, 2013

Many doctors unsure about participating in health exchanges

Albuquerque Business First, October 8, 2013



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Multimedia/Events

Webcast: Telemedicine—A Strategic Tool to Grow Revenue and Drive Efficiency

Date: November 19, 2013, 1:00–2:30 p.m. ET Learn how specialists and specialty services are reaching outside hospital and clinic walls to engage patients via the Internet, and how telemedicine innovators are overcoming challenges such as billing, scheduling and contractual agreements. Telemedicine pioneers share strategies proven to bridge access gaps, improve patient experience, and streamline care through new mobile technologies. Register Today >>>


HealthLeaders Media LIVE from Memorial Hermann: The Readmissions Master Plan

Date: December 3, 2013 | 12:00–3:00PM ET Find out how Memorial Hermann has slashed preventable readmissions through better communication, systemic accountability, and improved care for high-risk patients. Get real-world solutions, interactive Q&A, and lessons learned. Register Today Download the Free Case Study >>>




From HealthLeaders Magazine

A Fresh Look at End-of-Life Care

Providers must team with patients to determine the ultimate medical mission. >>>

 

Delivering Safety Over Convenience

 

Restructuring Reimbursements



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