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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.
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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.
Doctors Caught Between Patient Pain, Prescriptions – HealthLeaders Media
For some physician leaders, pain management may become a significant boon to their business, especially as the U.S. population ages. In a Health Leaders Media Industry survey this year, 37% predicted pain management will grow 1 to 5% over the next five years.
But doctors are on a precipice as they prescribe pain medication, especially long-acting and extended-release opioid analgesics such as oxycodone. Most are aware of the persistent potential for abuse, misuse, or mistaken use of the highly potent prescription drugs among patients. And the stress is mounting – for the docs.
States are tightening treatment requirements, while the federal government weighs the possibility of mandatory educational plans for doctors in their handling of opioids, putting federal officials at loggerheads with much of the medical establishment.
Some physicians are so upset over what they term the “bureaucratic” infringements, that they are considering no longer seeing patients who seek pain treatment. Instead, they would prefer to refer those patients to colleagues who are willing to prescribe potent analgesics.
See on www.healthleadersmedia.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.
House Bill to Press for One-Year SGR Delay – HealthLeaders Media
Rep. Michael Burgess (R-TX) said on Wednesday that he will submit legislation this week to delay for one year the implementation of the sustainable growth rate formula (SGR). Without the delay, or other action, physicians face a 28% cut in Medicare reimbursements in January 2013.
Burgess made the announcement at a meeting of the House Energy and Commerce Committee called to discuss innovations to reform Medicare physician payments.
He said that the SGR delay would allow Congress to get past the uncertainties presented by the upcoming elections, the expiration of existing tax policy, the extension of unemployment insurance, as well as potential debt limit debates.
The SGR formula was put in place as part of the Balanced Budget Act of 1997 to help control Medicare spending. It soon became apparent that significant cuts in physician reimbursements would be required to help reduce spending but since 2003 Congress has routinely declined to make those cuts.
See on www.healthleadersmedia.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.
In new effort to tackle health care fraud, government and insurers to scrutinize claims data
The Obama administration is upping the ante in the fight against health care fraud, joining forces with private insurers and state investigators on a scale not previously seen in an attempt to stanch tens of billions of dollars in losses.
Health and Human Services Secretary Kathleen Sebelius said in a statement Thursday that the new public-private partnership “puts criminals on notice that we will find them and stop them,” while Attorney General Eric Holder called it “a critical step forward” against fraud, an endemic problem plaguing programs like Medicare and Medicare as well as private insurance companies.
The analysis of data from Medicare, Medicaid and private health plans will look for suspicious patterns and other evidence that might indicate fraud, White House officials said. A “trusted third party” would comb through the data and turn questionable billing over to insurers or federal investigators.
See on www.washingtonpost.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.
Aurora Health Care and Aetna Form Accountable Care Collaboration, Offer New Commercial Health Care Products
AETNA Press Release regarding New Commwerical ACO Venture:
Aurora Health Care has joined with Aetna (NYSE: AET) to bring employers a new type of commercial health plan designed to improve employees’ health care experience and health outcomes, while controlling costs. The Aurora Accountable Care Network offers businesses a high-quality, affordable alternative in a time of rising health care spending.
“Aetna views accountable care organizations as a model for making health care work better for everyone.”
The Aurora Accountable Care Network offers a price guarantee to employers built upon a health care model that improves quality, outcomes and the patient experience. This type of price guarantee is possibly the first of its kind among accountable care models. Employers will see real savings in what they spend on health care as a result of improved patient outcomes and greater efficiencies. Cost savings will be specific to each employer, with the potential for an average 10 percent reduction based on the employer’s past claims expenses. The plans with Aetna will be effective beginning Jan. 1, 2013.
“This is a game changer,” said Nick Turkal, MD, Aurora Health Care’s president and CEO. “We are pleased to collaborate with Aetna to make our accountable care model available to the commercial health insurance market. As an employer, we have met national quality benchmarks among our own employees, while curbing our health care costs. Now we aim to replicate this success for others.”
Mark T. Bertolini, Aetna chairman, CEO and president, said, “We are building on our strong provider relationships to establish a nationwide accountable network that offers better care at a lower cost for everyone. Aurora Health Care has revolutionized health care in Wisconsin. Aetna’s industry-leading care management programs and consumer tools together with Aurora’s outstanding patient care model will lead to a better overall health care experience.”
See on www.businesswire.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.
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