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Friday, May 15, 2009

Daily news & Analysis

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Docs Spend About $31B Haggling with Insurers Annually

By: John Commins, for HealthLeaders Media, May 14, 2009

Physicians spend three hours per week–43 minutes on average per workday–haggling over claims, credentialing, authorizations, formularies, and other issues with health insurance plans, according to a study released today.

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Survey: Americans Want Answers on Health Reform Impact

By: John Commins, for HealthLeaders Media, May 15, 2009

A new survey finds that Americans want healthcare reform—they just can't decide what kind. The survey by the Stanford Center on Longevity, which so far has been taken by more than 2,000 people, explains different healthcare coverage strategies, their advantages and disadvantages, and asks participants to give their opinions and gauge their support. The reform options include: changing physician and hospital payment incentives; enhanced independent review of drugs, treatments and procedures; single-payer system; state Children's Health Insurance Plan and Medicaid expansion; government-mandated plan participation; universal health vouchers with regional oversight boards; and expansion of health savings accounts.

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GOP is Feeling Left Out of Health Reform Debate, Calls for Meeting with Obama

By: Janice Simmons, for HealthLeaders Media, May 15, 2009

Leading House Republicans, apparently unhappy over being excluded from a Wednesday meeting with the president over healthcare reform and later a closed-door meeting of the House Energy and Commerce Committee to draft health reform legislation, are calling for President Barack Obama to meet with them.

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Diversity, Transparency Issues Raised at Comparative Effectiveness Hearing

By: Janice Simmons, for HealthLeaders Media, May 15, 2009

The Federal Coordinating Council for Comparative Effectiveness Research took its second listening session on the road from Washington on Wednesday. At the session in Chicago, the council, authorized under the American Recovery and Reinvestment Act to assist federal agencies in coordinating and comparing the effectiveness of health services research, heard requests for addressing disparities and creating better transparency for research.

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Criminal Charges Possible in WellCare Fraud Case

By: Kristen Kohrt, for HealthLeaders Media, May 14, 2009

By entering a deferred prosecution agreement with the Department of Justice and agreeing to pay $80 million in restitution and forfeiture in order to avoid healthcare fraud charges, WellCare Health Plans, Inc., also left open the opportunity for the feds to prosecute individuals involved in the case.

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10 Lessons From the RAC Demonstration Program

By: Andrea Kraynak, for HealthLeaders Media, May 14, 2009

The Medicare Recovery Audit Contractor demonstration project has come and gone, but many providers learned valuable lessons during the process.

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Specialty Facilities Don't Threaten General Hospitals, Study Says

By: Karen M. Cheung, May 15, 2009

Oftentimes, there exists a contentious feud between supporters and objectors to specialized institutions that cater to a lucrative payer mix. Despite ongoing criticism that specialty hospitals that focus on profitable cardiac and orthopedic services would divide the haves and have-nots, a recent study found that isn't necessarily the case. In fact, specialty facilities do not threaten surrounding general hospitals and safety net hospitals, according to General Hospitals, Specialty Hospitals, and Financially Vulnerable Patients from the Center for Studying Health System Change.

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Cash for Computers

By: John Commins and Jim Molpus, for HealthLeaders Magazine, May 11, 2009

With an 11-figure incentive to invest in information technology and electronic medical records, healthcare executives need to determine if this offer from Uncle Sam is the kind of help that they are prepared to accept.

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Another Band-Aid on Medicare's Physician Payment Problems

By: Elyas Bakhtiari, for HealthLeaders Media, May 14, 2009

I hoped that I would never again have to write one of those Medicare-payments-are-about-to-be-cut-and-time-is-running-out articles. It looks like I got my wish, for now.

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Can Medical Homes Live Up to Their Lofty Expectations?

By: Janice Simmons, for HealthLeaders Media, May 14, 2009

Last month, it was reported that many lawmakers on Capitol Hill were promoting the "medical home" approach to providing quality healthcare. So, has its time finally come—or not?

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