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The Promise And Peril Of Accountable Care For Vulnerable Populations: A Framework For Overcoming Obstacles
Accountable care organizations (ACOs) are a promising payment model aimed at reducing costs while also improving the quality of care. However, there is a risk that vulnerable populations may not be fully incorporated into this new model. The authors define two distinct vulnerable populations, clinically at-risk and socially disadvantaged and discuss how ACOs may benefit each group. The authors provide a framework to use in considering challenges for both vulnerable patients and health systems on the path to accountable care. The authors identify policies that can help overcome these obstacles: strategies that support ACO formation in diverse settings and that monitor, measure, and reward the performance of providers that reach all patients, including vulnerable populations.
See on content.healthaffairs.org
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
New Yorker — Atul Gawande: Can Hospital Chains Improve the Medical Industry?
Restaurant chains have managed to combine quality control, cost control, and innovation. Can health care?
Big chains thrive because they provide goods and services of greater variety, better quality, and lower cost than would otherwise be available.
Medicine, though, had held out against the trend. Physicians were always predominantly self-employed, working alone or in small private-practice groups. American hospitals tended to be community-based. But that’s changing. Hospitals and clinics have been forming into large conglomerates. And physicians—facing escalating demands to lower costs, adopt expensive information technology, and account for performance—have been flocking to join them. According to the Bureau of Labor Statistics, only a quarter of doctors are self-employed—an extraordinary turnabout from a decade ago, when a majority were independent. They’ve decided to become employees, and health systems have become chains.
See on www.newyorker.com
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
WNYC News – Metro Area Hospital To Be Hit with Federal Fines for ‘Frequent-Flyer’ Patients
Several New York-area hospitals will lose millions of dollars in federal Medicare payments, because too many of their patients keep coming back — and the government’s tired of paying for it.
The list of penalized hospitals includes some of the region’s biggest players: city hospitals, like Bellevue, Jacobi, Coney Island and Elmhurst; academic medical centers such as Beth Israel, St. Luke’s-Roosevelt and Mt. Sinai; and suburban ones like North Shore and Hackensack medical centers.
The federal government says if hospitals took better care of patients — especially ones with high needs — they wouldn’t be “frequent flyers,” constantly being readmitted and costing taxpayers billions of dollars.
Starting in October, the Centers for Medicare and Medicaid Services will start withholding up to 1 percent of Medicare payments from hospitals with too many “frequent flyer” patients. The maximum penalty will climb to 3 percent by October 2014.
Medicare came up with its list of “frequent flier” hospitals by looking at the 30-day readmission rate for patients with heart failure, heart attack and pneumonia.
See on www.wnyc.org
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
Congressional Budget Expert Says Preventive Care Will Raise — Not Cut — Costs
In yet more disappointing news for Democrats pushing for health care reform, Douglas W. Elmendorf, director of the Congressional Budget Office, offered a skeptical view Friday of the cost savings that could result from preventive care — an area that President Obama and congressional Democrats repeatedly had emphasized as a way health care reform would be less expensive in the long term.
Obviously successful preventive care can make Americans healthier and save lives. But, Elmendorf wrote, it may not save money as Democrats had been arguing.
In their continuing struggles with CBO, Democrats from President Obama on down have expressed frustration that Elmendorf doesn’t give Democrats’ health care reform proposals sufficient credit for cost cutting through preventive care.
See on abcnews.go.com
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
Better medicine, brought to you by big data
Slowly but surely, health care is becoming a killer app for big data. Whether it’s Hadoop, machine learning, natural-language processing or some other technique, folks in the worlds of medicine and hospital administration understand that new types of data analysis are the key to helping them take their fields to the next level.
See on wesgbrooks.visibli.com
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
QIPP @lert: Accountable care strategies: lessons from the Premier Health Care
Accountable care strategies: lessons from the Premier Health Care Alliance’s accountable care collaborative — This report shares the perspectives of hospitals and health systems taking part in the Premier health care alliance’s accountable care implementation collaborative.
See on qippalert.blogspot.fr
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
Virginia health-care professionals urge Medicaid expansion
An additional 100,000 Hampton Roads residents would qualify for Medicaid under the proposed expansion authorized by the Affordable Care Act to take effect in 2014, according to new figures released by the Urban Institute. Those account for more than a quarter of the newly eligible in the whole state.
Speakers at a public meeting of the Hampton-Newport News Community Services Board at the Embassy Suites in Hampton on Thursday outlined the potential economic and health impacts of “Obamacare.” Despite the anticipated costs, all urged the state to adopt the Medicaid expansion for its potential benefits for the general health of the population, and in particular for those with behavioral health diagnoses as the ACA mandates parity for mental health treatment.
See on www.dailypress.com
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
Health-care reform: Has Team Romney embraced the individual mandate? – CSMonitor.com
Conservatives have howled over the health-care reform law’s requirement that people buy insurance. But recent comments from the Romney campaign have some wondering if the presumptive GOP nominee is now embracing it.
See on www.csmonitor.com
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
Papa John’s CEO says health care reform law will increase price of pizza
See on Scoop.it – Hot Topics in Healthcare Law and Regulation
Expect to pay more for pizza orders in 2014 when key provisions of the health care reform law go into effect, says Papa John’s International Inc. CEO John Schnatter.
See on www.businessinsurance.com
Whistleblower lawsuit Florida Hospital: Whistleblowers lawsuit against Florida Hospital claims Medicare fraud
A whistle-blower lawsuit based on insider information from a former Florida HospitalOrlando billing employee and a staff physician alleges that seven Adventist Health hospitals in Central Florida have overbilled the federal government for tens of millions of dollars in false or padded medical claims.
The suit claims Florida Hospital used improper coding for more than a decade to overbill Medicare, Medicaid and Tricare, all federal government payors. In addition, it alleges, the hospital commonly overbilled for a drug used, for example, in MRI scans and billed for computer analyses that were never performed.
See on articles.orlandosentinel.com
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
Joseph Rugg's Health Law Blog 