Kaiser Health News asked a range of health policy experts the following question: If you could make only one change to Medicare to control costs, what would it be and why? Edited excerpts of their answers follow. The article references 19 experts.
A key cost-saving measure in Gov. John Kasich's transformation plan for Medicaid—the state's insurance for the poor—has been approved by federal regulators, the governor's office said today. Ohio has reached an agreement with the Centers for Medicare and Medicaid Services to coordinate care across the state for those seniors who qualify for both Medicare and Medicaid. Those dual-eligible residents are often aged 65 or older and meet certain low-income requirements.
Executives of Mercy Health System of Maine deny that they misled the Massachusetts company that negotiated to buy the hospital group in Greater Portland before the talks ended abruptly on Friday. Mercy officials responded Tuesday to a report in The Boston Globe that said Steward Health Care System "unilaterally withdrew" from talks because the Catholic nonprofit organization misrepresented the condition of its finances and operations.
Aetna Inc, the third largest U.S. health insurer, said on Wednesday that by 2014 it expects to be part of about 15 healthcare exchanges being established under government reforms. Aetna, one of the companies on the front lines of healthcare changes in the United States, told analysts and investors that it believes an increase in the number of customers from the new market places will likely contribute to its growth. An estimated 30 million more people are expected to join the insured over the next decade because of the U.S. Patient Protection and Affordable Care Act of 2010. Millions of those will seek their health insurance through the exchanges.
A new study by a nationally acclaimed research group suggests that whether or not a patient undergoes a mastectomy may depend largely on where she lives. The statistical report, sponsored by the Dartmouth Atlas Project and released Wednesday, found significant variations in the use of certain surgeries on Medicare patients in national, regional and local markets. Shannon Brownlee, the study's lead author and an instructor at the Dartmouth Institute for Health Policy & Clinical Practice, attributes the differences to physicians who impose their preferences on uninformed patients. "Many patients are not even aware that elective surgeries are a matter of choice," Brownlee said in a conference call.
The market for revenue cycle management (RCM) consulting and outsourcing is growing, a new KLAS Research report says. Increasing pressures on hospitals to cut costs, as well as the diversion of hospital resources to Meaningful Use and ICD-10, are among the factors driving the trend, noted the Orem, Utah-based research firm. "What we're seeing in some instances are folks choosing to use outside resources so they can have some more focus on Meaningful Use," said Mike Smith, VP of financial and services research for KLAS, in an interview with InformationWeek Healthcare.