Reimbursement

Advocates for the poor and hospital executives say states' attempts to cut Medicaid hospital coverage will restrict patients' access to care, force hospitals to absorb more costs and lead to higher charges for privately insured patients.

Healthcare Information Xchange of New York (HIXNY) announced Friday that it has connected its HIE with the cloud-based electronic health record from athenahealth.

One of the underreported results of the public comments period for accountable organizations this past summer was the emergence of a gap between patient-centric industry groups and those associations representing care providers of various sizes.

A significant percentage of the nation’s pediatricians are carrying necessary vaccines at their own expense, Athenahealth, Inc. recently announced. The announcement accompanied the launch of the company’s new VaccineViewSM, a program designed to shed light on the impact of vaccine reimbursement costs on U.S. pediatric practices.

WellPoint and UnitedHealthcare are among private payers that have been testing new models to improve patient outcomes and lower costs, even before the Centers for Medicare and Medicaid Services released rules around new payment and care delivery approaches.

In early October the U.S. Preventive Services Task Force, an advisory panel that helps inform the government on preventive healthcare, downgrade its recommendation on the PSA test for prostate cancer screening to a grade of D. It recommended doctors not routinely prescribe the test because "there is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits."

CMS issued the final rules for accountable care organizations (ACO) on Thursday and, in so doing, sparked excitement throughout healthcare with what initially appears to be a more achievable set of qualifying parameters. But it will take some time for the healthcare industry to absorb and understand the changes.

As Joseph Kvedar, MD, director of Partners Healthcare's Center for Connected Health, looked out upon a crowded ballroom at Boston's Park Plaza Hotel Thursday afternoon, he was reminded of a concept hatched roughly two decades ago.

Providers offer options for the Supercommittee to cut Medicare costs by making better coverage decisions and discouraging routine unnecessary services.

The American College of Physicians, which represents 132,000 internal medicine specialists, is proposing a privacy rule that says researchers should maximize appropriate uses of information to achieve scientific advances without compromising ethical obligations to protect individual welfare and privacy.