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While many private payers across the country have rushed to launch payment initiatives wrapped around healthcare delivery models like ACOs and patient-centered medical homes (PCMH), Washington-based Premera Blue Cross has found success via its unique payment model it calls Global Outcomes Contracting.
A lawsuit filed July 3 by roughly 50 doctors and a number of California medical groups including the Los Angeles County Medical Association and the California Medical Association accuses health insurer Aetna of regularly and systematically threatening doctors within its network with having their contracts with Aetna terminated for making out-of-network referrals.
Even as some governors vow to bow out of expanding their Medicaid programs in the wake of the Supreme Court upholding the Affordable Care Act, WellPoint Inc. announced July 9 it will acquire managed care company Amerigroup for $92 per share or roughly $4.9 billion.
Fifteen years after the Omnibus Budget Reconciliation Act (OBRA) directed the Centers for Medicare & Medicaid Services (CMS) to implement intermediate sanctions for noncompliant home health agencies (HHAs), the federal agency has finally complied.
Critics of a pilot program designed to lower the cost of medical equipment purchased by the Centers for Medicare & Medicaid Services (CMS) recently received support for their concerns in a new report released by the California Institute of Technology (Caltech). But while the models used by researchers confirmed earlier outside assessments of the program, the director of the program says the researchers got it wrong.
An analysis of hospices active in Medicare between 1999 and 2009 published in the June issue of Health Affairs is an attempt to shed some light on the degree of the changes transforming the industry and to point the industry in the direction it should be focusing on.
The home care industry has enormous potential for business people. One segment of the business world has already figured this out: franchise business owners
Over the last seven months, St. Joseph Health System (SJHS), a large Catholic healthcare organization located across California and western Texas, has been using a multi-disciplinary approach to engage its physicians and clinicians in understanding the impact of clinical practice patterns and resource variability.
When it comes to healthcare and patient collections processes, good communication is key, said Sunni Patterson, president and CEO of RMK Holdings, a healthcare collections company in Chicago. However, she believes that for a large number of hospitals and healthcare systems across the country, communication between healthcare providers, payers and patients is the missing piece.
Chief financial officer John Cornell at Meadows Regional Medical Center, a 64-bed rural hospital in Vidalia, Ga., spoke recently with Healthcare Finance News Associate Editor Kelsey Brimmer regarding some of the most prominent financial issues that rural hospitals face in the future and have been facing in the last few years.