HealthLeadersMedia.com - Finance News & Analysis

Lower ED Margins Demand a Better Strategy

Fri, 24 May 2013 12:35:00 GMT

In this new Intelligence Report, we examine how resolving organizational problems in the emergency department will remain a challenge as demand for ED services increases, overcrowding elevates patient safety concerns, and quality metrics draw greater attention.

Healthcare Costs Hit Record High, But Growth Rate Slows

Fri, 24 May 2013 12:28:00 GMT

The 2013 Milliman Medical Index pegs the annual cost of PPO coverage at 6.3% higher than last year. Physician and other professional services account for one third of annual healthcare spending.

Clock ticking on full Medicaid expansion funds

Fri, 24 May 2013 11:12:00 GMT

States still mired in the fight over the Obamacare Medicaid expansion are starting to give up on their first year of full funding — and it's unclear whether they would be able to tap into the money before 2015. Expansion remains an open question in about a dozen states after months of legislative fights. As more states continue to wrap up their budgets, some are already looking to next year's legislative sessions as their next shot at the expansion, even amid calls for state legislatures to return for special sessions.

CA picks 13 health plans for state-run insurance market

Fri, 24 May 2013 11:03:00 GMT

After weeks of negotiations, California said it has selected 13 health plans for a new state-run insurance marketplace where as many as 5 million people will shop for coverage next year. Officials at Covered California, the state agency implementing the federal Affordable Care Act, said Thursday that the winning bidders reflected a mix of large commercial insurers and smaller regional plans. The state also released some sample rates, illustrating how premiums will vary across health plans in this new market.

Insurance premiums after ACA kicks in remain a mystery

Fri, 24 May 2013 11:00:00 GMT

Whether health insurance rates under the Affordable Care Act will rise or fall is still a big unknown, as a recent congressional report made clear. Two large New Jersey insurers submitted widely divergent estimates for the future cost of insurance premiums -- one saying they could rise as much as 19 percent, another saying they could fall by up to 25 percent. In addition, one insurer said premiums for small businesses would rise by 16 percent. The costs were provided to Congress with the proviso that the estimates would remain anonymous.

IL Senate approves health insurance exchange

Fri, 24 May 2013 10:49:00 GMT

The Illinois Senate took a key step toward implementing the Affordable Care Act, also known as "Obamacare." Senators approved the creation of a "health insurance exchange." Starting next year, Americans must have insurance or face penalties. Under the Affordable Care Act, states have the option to create their own health insurance exchanges or partner with the federal government. A health insurance exchange is at the heart of the Affordable Care Act. It's a marketplace where people who don't otherwise have insurance -- like through an employer -- are supposed to be able to find it.

$6.4B Henry Ford, Beaumont Merger Failed on Cultural Hurdles

Thu, 23 May 2013 12:49:00 GMT

A merger between two Michigan healthcare providers has been called off because of stark cultural differences between them, observers say. Those differences include the patient populations they each serve and the organizations' physician compensation models.

Less Blood Testing for Some Surgeries Safe, Cost Effective

Thu, 23 May 2013 12:29:00 GMT

The ordering and testing of blood for surgery that rarely requires blood transfusions is expensive and "overutilized" by hospitals, researchers say. At Johns Hopkins alone, more appropriate blood ordering practices could save $200,000 a year.

Cost cuts further UC Health expansion

Thu, 23 May 2013 12:18:00 GMT

The expansion of UC Health is accelerating, from Florence to Trenton, from babies to proton beams. Created in 2010 from the remnants of the collapsing Health Alliance of Greater Cincinnati, the system set up by the University of Cincinnati is poised to spend more than $300 million during the next few years, at the same time it's slashing expenses to try to get more efficient. Every big health system in the region is pursuing the same seemingly opposite goals, nudged by the looming specter of health care reform to take effect in 2014 and the relentless march toward consolidation of doctors and services under huge corporate umbrellas.

Opinion: Health IT—Make sure policy umbrella is big enough for all

Thu, 23 May 2013 12:13:00 GMT

The growing trend toward incorporating health information technology (HIT) and patient-defined and patient-generated data into the healthcare delivery system is clear. From funding included in the American Recovery and Reinvestment Act of 2009 to provisions included in the 2010 Affordable Care Act, to the call for inclusion of patient-generated data in Stage 3 meaningful use, HIT implementation is an essential component of federal plans to improve healthcare quality and lower costs. The trend may be clear, but we still need a better comprehension of how broad the range of patient-generated data really is.

Lake Erie Regional Health System cuts jobs at two hospitals

Thu, 23 May 2013 12:08:00 GMT

The parent corporation of Lake Shore Health Care Center in Irving and Brooks Memorial Hospital in Dunkirk has laid off at least 40 employees over the past two days to lower costs and eliminate overlapping services, The Buffalo News has learned. Lake Erie Regional Health System of New York laid off about 40 employees at Lake Shore Health Care across a variety of departments, with workers learning their fates late Tuesday and Wednesday, according to a current hospital employee and an employee who was laid off, both of whom spoke on condition of anonymity.

Opinion: Colonoscopy mill operator doesn't concern insurance company

Thu, 23 May 2013 12:02:00 GMT

To hear Health Plan of Nevada's advocates tell it, Dr. Dipak Desai was a master of deception. He was a real sleight-of-hand artist, a veritable David Copperfield of the colonoscopy. The fact Desai and a nurse anesthetist are on trial facing a list of criminal charges including second-degree murder illustrates the fact he's the one at fault. HPN, on the other hand, is a dedicated and charitable servant of nearly 500,000 Nevadans' health care needs. Its reputation has been besmirched by last month's staggering $500 million punitive damage award for its role in the hepatitis C outbreak at Desai's now-closed Endoscopy Center of Southern Nevada.

Uncompensated Care Faces a Double Hit in Some States

Wed, 22 May 2013 12:27:00 GMT

Hospitals in states that opt not to expand Medicaid are at a severe disadvantage to their counterparts in other states, not only because they will miss out on additional Medicaid-based reimbursement, but also because they will face the same cuts in disproportionate share funding as everyone else.

House Lawmakers Grill CMS Over Health Exchange Navigators

Wed, 22 May 2013 12:11:00 GMT

The role of navigators, expected to help millions of uninsured make their way through the health insurance market, came under fire Tuesday by members of Congress who raised questions about oversight and the role of the IRS in the implementation of healthcare reform.

Loophole in healthcare law could stick doctors with tab

Wed, 22 May 2013 11:05:00 GMT

A loophole in California's upcoming health care overhaul could be exploited by families gaming the system or responding to hardship in a way that doctors say could leave a pile of unpaid bills. A chain of events would create a two-month period during which a family has medical coverage but no insurer must pay its claims. Nonpayment of premiums for subsidized policies would trigger the oddity: Federal law provides a three-month grace period before cancellation - but insurers are responsible only for the first month.

End of health price secrecy may be starting in Miami

Wed, 22 May 2013 11:02:00 GMT

When Medicare released thousands of health-care prices this month, one of the biggest criticisms was that these figures didn't represent what patients actually paid. Medicare, for example, pays hospitals on a set fee schedule, regardless of their prices. Health insurance plans typically negotiate a lower rate with a hospital than the sticker price that showed up in the new data. Those prices still remain secret — but that may change. Spurred by the release of the Medicare data, the chief executive of Mt. Sinai Medical Center in Miami has now pledged to release those negotiated rates that tend to be kept secret. Via MedCity News:

Humana CEO sticks with Medicare focus amid funding pressure

Wed, 22 May 2013 11:00:00 GMT

As the federal government squeezes payments for private Medicare plans, Humana Inc. (HUM), the big health insurer most tethered to the government health program, has no plans to shift gears. Instead, the Louisville, Ky., company is pressing ahead with efforts to grow Medicare membership, while making its plans work more efficiently through methods such as providing more intense care upfront for sicker patients. Like other companies running Medicare Advantage plans, which cover more than 14 million Americans, Humana has to find ways to make a good business by doing more with less.

18 CT hospital execs' paychecks top $1M

Wed, 22 May 2013 10:49:00 GMT

Eighteen Connecticut hospital executives received pay packages over $1 million last fiscal year, as many of the state's acute care providers saw their financial performance improve from a year earlier, a new report says. The state's two largest hospitals—Hartford Hospital and Yale New Haven Hospital—each had four senior executives that received million-dollar plus pay packages last fiscal year, while Stamford Hospital had two administrators earn over $1 million, according to a new report from the state's Office of Health Care Access, which regulates hospitals. The OHCA report did not name individual administrators, but it did list the top 10 paid positions at the state's 30 acute care hospitals.

Public in Deep South supports expanding Medicaid, but lawmakers don't

Wed, 22 May 2013 10:45:00 GMT

Even though governors and lawmakers in five Deep South states oppose a plan to cover more people through Medicaid under the health care overhaul, 62 percent of the people in Alabama, Georgia, Louisiana, Mississippi and South Carolina support expanding the program, according to a new poll. The level of support for expanding Medicaid – the state and federal health insurance program for the poor and disabled – ranged from a low of 59 percent in Mississippi to a high of 65 percent in South Carolina, according to the poll by the Joint Center for Political and Economic Studies, a leading research and public policy think tank that focuses on African-Americans and other people of color.

Q&A: Catholic Health Initiatives' New Senior VP for Capital Finance

Mon, 20 May 2013 17:49:00 GMT

Nick Barto recently stepped up his role at the 80-hospital health system to increase CHI's focus on strategic finance in light of healthcare reform and the shift in patient volumes to outpatient settings.