Reimbursement

The Centers for Medicare & Medicaid Services' latest proposals to curb the overuse of painkillers could have a lot of unintended consequences, hospice and palliative care advocates are warning.

Tenet Healthcare Corp., the nation's third largest for-profit hospital operator, said Tuesday it expects 15 percent of its uninsured patients to get covered this year as a result of the Affordable Care Act.

Although highly touted, the patient-centered medical home model failed to lower use of services or total costs and produced little quality improvement over three years, research in the latest Journal of the American Medical Association (JAMA) has found.

The federal government is proposing a 3.5 percent Medicare Advantage rate reduction, but all other factors considered, how much could the cuts translate into?

Maryland's troubled insurance exchange is ending its contract with the lead IT developer and might be trying to recoup some of the millions that've been paid out, while calling in the nation's go-to HIX fix-it firm.

The healthcare industry has lagged behind retail, banking and other sectors in the adoption and use of data to improve efficiencies and services. Recently though, healthcare has seen increased interest in this approach as new payment models and reform initiatives require greater internal visibility and external transparency.

Aetna CEO Mark T. Bertolini believes that when times are tough, people want to hear the truth. In his Monday morning opening keynote here at HIMSS14, Bertolini was prepared to speak the unvarnished truth.

The recent delay of the employer mandate for medium-sized businesses will hurt not-for-profit hospitals because it postpones increased revenues from expanded coverage of previously uninsured patients, and the subsequent reduction in bad debt and charity care it would bring, a Moody's report said.

After watching the failures and successes of other states and HealthCare.gov, Idaho is making its own foray into running an insurance exchange, tapping a young Silicon Valley tech firm and an established Beltway contractor.

Since the recession first began in 2008, hospitals and health systems have continually seen a drop in inpatient volumes. Most industry experts say they expect more of the same for the rest of 2014 and even the next five years or so.