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  June 4, 2014 Follow us on FacebookFollow us on TwitterJoin us on LinkedInRSS feed

Billionaire Matchmakers Wanted by Healthcare Industry

Christopher Cheney, Editor for HealthLeaders Media

There are billions of dollars of future revenue sitting on the value-based delivery system table. Payers and providers have to find a way to work together to seize the opportunities in front of them. >>>

 

Editor's Picks

Medicare Overpaid Physicians $6.7B For Miscoded Claims

An examination of medical claims records by federal officials finds that more than half of doctors' claims for patient evaluations and related services had incorrect codes or lacked the necessary documentation. >>>

Datapalooza: CMS Unveils More Hospital Pay Data

Data made public by CMS includes information comparing the average hospital charges in 2012 for the 100 most common Medicare inpatient stays at more than 3,000 hospitals. >>>

The Hospital of the Future is Not a Hospital

Pursuing expensive inpatient volume in the traditional sense is a strategic dead end. Any new construction undertaken by hospitals and health systems should be based on adaptability, patient flow, and efficiency gains—not bed count. >>>

Pioneer ACO Program Awaits New Rules

CMS may release as soon as this summer new rules for Medicare's gainsharing programs and a decision on whether to launch a second round of Pioneer ACO participant recruitment. >>>

Prescription for Narrow Networks: Add Transparency

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. >>>

CMS Opens Physician Registration for Sunshine Act

The process is going forward despite the protestations of the American Medical Association, which has complained that CMS "has missed nearly every deadline laid out in the law and regulations to implement it." >>>

Fresh Tech-Based Concerns Show No Time for Complacency

IT leaders at healthcare providers are under siege. ROI, legacy systems, cloud software, and the EHR wars are a few of their current concerns. >>>



LIVE Webcast

Webcast: Hospitals Developing Health Plans—Key Steps to Becoming a Provider-Payer

Date: July 16, 2014, 1:00–2:30 p.m. ET Health plan leaders from North Shore-LIJ and Sanford Health outline the strategic transition from provider to payer, and new opportunities for controlling costs, managing risk, and maximizing reimbursements. Register Today >>>



News Headlines

Feds overpaid $70B to Medicare Advantage

The Hill, June 4, 2014

Obama said to weigh Cleveland Clinic chief for VA post

Bloomberg, June 4, 2014

The health data revolution enters an awkward adolescence

NPR, June 4, 2014

L.A. doctor charged with $33 million Medicare fraud

CBS Los Angeles / Associated Press, June 4, 2014

Medicare charges vary by hospital, report finds

The Hill, June 3, 2014

GAO report finds self-referring doctors may be driving up healthcare costs

The Hill, June 3, 2014

Ban lifted on Medicare coverage for sex change surgery

The Washington Post, June 3, 2014

Medicare could save billions by scrapping random drug plan assignment

Kaiser Health News, June 3, 2014

Obamacare prompts states to revisit their healthcare rules

Huffington Post / Associated Press, June 2, 2014

Medicare on drugs: 24,000 tests for 145 patients

Reuters, May 30, 2014



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Multimedia/Events

HealthLeaders Media LIVE From Intermountain: Primary Care-Mental Health Integration

Date: June 17, 2014 | 12:00–3:00PM ET Find out how Intermountain Healthcare developed a team-based approach that ensures the effective assignment of mental health professionals, along with a care process model built upon a systematic, evidence-based treatment algorithm that is collaborative and measurable. Register Today Download the Free Case Study >>>




From HealthLeaders Magazine

Presidents, CEOs, and the New Leadership Model

Some hospital CEOs, used to captaining their own ship, are finding that healthcare reform means there are fewer opportunities to run things as they see fit. Maybe that's a good thing. >>>

 

Transitions of Care Go Digital

 

Making It All Public



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