Reimbursement

As the number of mobile health apps continue to grow, along with public demand for them, one company has found a way to open the pipelines of innovation by eliminating the need for multiple application programming interfaces (APIs).

The International Federation of Health Plans released its 2012 Comparative Price Report, detailing its annual survey of medical costs per unit in the United States and 11 other developed countries, which again showed average costs in this country far exceed those in the rest of the world.

Only 10.9 percent of payments to doctors and hospitals in the commercial sector in 2013 are linked to their performance or designed to cut waste, according to the National Scorecard on Payment Reform released by the Catalyst for Payment Reform (CPR), a non-profit group of employers and large healthcare purchasers that advocates for paying for value.

After a federal district judge temporarily blocked a Georgia prompt payment law applying to self-funded plans and third party administrators (TPAs), the American Medical Association (AMA) is challenging some of the pillars of federal preemption under the Employee Retirement Income Security Act (ERISA).

In the first year of new medical loss ratio (MLR) requirements, insurers spent less than 1 percent of premium revenue on rebates or quality improvements, according to an analysis by the Commonwealth Fund.

Accountable care organizations might be today's hope for grappling with healthcare costs and bumping up quality, but according to one expert, they are doomed to fail without one key element.

The payment of higher Medicare rates to physicians and hospitals in regions that have good health outcomes and lower costs, while reducing payment rates where there is lesser quality and higher costs will not drive individual providers to deliver care more efficiently reports the Institute of Medicine (IOM).

Healthcare is part of the service industry and increased competition amongst providers should lead to cost stabilization and advancements in healthcare services. Unfortunately, multiple barriers limit the healthcare industry from behaving like other service industries.

You should read Dr. Scott Gottlieb's opinion piece in the Wall Street Journal (The Doctor Won't See You Now. He's Clocked Out). He argues that ObamaCare is making independent physician practices obsolete by forcing physicians to work for big hospitals as part of ACOs, is imposing high costs for information technology on those who try to remain independent, and that the Administration's policies will have the ironic consequence of driving up costs since employed physicians are less productive.

New research from the Urban Institute and the Robert Wood Johnson Foundation shows that hospitals can expect to pull in an additional $293.9 billion dollars between 2013 and 2022 if all states opt to expand Medicaid as outlined in the Affordable Care Act.