Reimbursement

Aetna and post-acute care provider Genesis HealthCare announced last week an incentive-based contract aimed at rewarding Genesis for creating a coordinated care approach that reduces hospital readmissions for Aetna members.

Even as Oklahoma and Kansas recently said 'no thanks' to federal money aimed at helping them with the health information technology platform needed to create health insurance exchanges, the Departments of Health and Human Services and Treasury last week awarded $185M more to drive the creation of the exchanges across the country.

GAO is urging the Centers for Medicare and Medicaid beef up its approach to physician quality reporting, recommending CMS be more methodical in order to make the reports more reliable.

To help U.S. hospitals manage risk and take full advantage of the new healthcare payment models, Thomson Reuters has introduced a suite of payment reform tools.

Two "Blue" health insurers announced earlier this week a partnership intended to expand Medicaid insurance and services nationally through a combined acquisition of AmeriHealth Mercy, which serves nearly 800,000 Medicaid members in three states.

Thomson Reuters has launched a suite of new payment reform tools designed to help U.S. hospitals manage risk and seize opportunities as new healthcare payment models go into effect.

After reading the July edition of Health Affairs, I'm concerned about the impact of Accountable Care Organizations (ACOs) on cost trends in the US health care system.

Primary care doctors are continuing to ramp up the pressure on the Centers for Medicare & Medicaid Services over how Medicare's physician payment rates are set. The latest volley is a suit filed by a group of primary care physicians from Georgia claiming CMS and HHS are violating federal laws by relying on the RUC.

CT scans in the emergency room have gone up dramatically in recent years. A new study links the increase in CT scans to fewer hospital admissions.