Reimbursement
The federal government has uncovered a string of alleged Medicare fraud attempts totalling $223 million and involving 89 individuals in eight cities.
A new report examining the state of the skilled nursing industry finds that there have been steady quality improvements since 2003 but more can be done.
Colorado HealthOP, the state's consumer operated and oriented plan (CO-OP), has signed an agreement with the broker network Warner Pacific to market its health plans, in the first relationship between agents and state health cooperatives.
The Centers for Medicare & Medicaid Services (CMS) is looking to more than a dozen dual eligible demonstrations to fulfill the quality improvement and cost saving aims of the Affordable Care Act, although in the five demonstrations approved so far, the exact sources of projected savings remain largely unclear, according to the Kaiser Family Foundation.
The number of health plans that expect more than half their business will be under value-based models is expected to triple in the next five years according to a new research report released last week by health information network Availity.
Conventional wisdom is that cutting Medicare rates shifts the burden to the private sector, but an intriguing article in Health Affairs reaches a counterintuitive conclusion.
Cigna has announced that it will enlist the help of MDLIVE, a developer of telehealth technology and services, to offer eligible health plan members round-the-clock online video consultations with internal medicine, family practice and pediatric doctors.
Congressional Republicans are proposing new ideas for changing Medicaid, suggesting models based on the 1996 federal welfare reform law, and proposing a bill that would base federal allocations on population size and patient categories.
A recent policy analysis from the National Institute for Health Care Reform (NIHCR), written by Carrier and other researchers from the center, reviews the various types of quality measurements and discusses ways in which payers can help make quality information more available, reliable and usable.
Over the years, with such large gaps in hospital safety and quality, many public and private payers have been pushing for greater hospital accountability through clinical quality measurement and reporting initiatives.