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Reform Update: CMS won't limit flexibility of Oregon CCOs, state says
By Virgil Dickson | August 26, 2014 | Basic Web Basic Web Subscription Details
The CMS and Oregon are stepping back from an apparent clash over how the state is paying the managed-care organizations serving Medicaid beneficiaries in its nationally watched Medicaid demonstration. State officials and leaders of Oregon's coordinated-care organizations had expressed strong...
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Sharp HealthCare ACO drops out of Medicare's Pioneer program
By Bob Herman | August 26, 2014 | Basic Web Basic Web Subscription Details
Another Medicare Pioneer accountable care organization has exited the program, renewing questions about its long-term sustainability. Sharp HealthCare, a five-hospital system in San Diego, said in its third-quarter financial statement that it dropped out of the Pioneer ACO program.
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Medicare ACOs can learn lessons from earlier demo project
By Melanie Evans | August 26, 2014 | Basic Web Basic Web Subscription Details
The precursor to Medicare's large and growing accountable care program ran five years and ended the month after the Affordable Care Act became law. The results, summarized in a new report, have proved prescient and may inform policy changes the CMS is expected to issue soon.
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News
Reform Update: Providers still skittish of CMS' renal ACO initiative
By Sabriya Rice | August 25, 2014 | Basic Web Basic Web Subscription Details
With just a few months before its launch, some providers are expressing frustration with a CMS initiative aimed at testing innovative payment and care-delivery models specifically geared toward patients with end-stage renal disease. Too many questions remain about key details and the framework...
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News
Billing Medicare for poor care not a false claim, court rules
By Bob Herman | August 25, 2014 | Basic Web Basic Web Subscription Details
A recent appellate court ruling in favor of an Illinois nursing home could shield other healthcare providers from False Claims Act allegations that involve poor quality of care.
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Presbyterian Healthcare Services sees higher profitability under Medicaid expansion
By Beth Kutscher | August 25, 2014 | Basic Web Basic Web Subscription Details
Presbyterian Healthcare Services, the Albuquerque system that has hospital and health plan operations, reported that the state's revamped Medicaid program led to higher profitability in the second quarter of the year.
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Information
Medicaid insurers prodding Mass. on funds
By Boston Globe | August 20, 2014
Buckling from more than $140 million in losses since the start of the year, companies that insure Medicaid patients are pressing Massachusetts Gov. Deval Patrick's administration to increase payments they receive from the state for serving low-income residents.
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Reform Update: Arkansas may make Medicaid enrollees fund HSAs
By Steven Ross Johnson | August 19, 2014 | Basic Web Basic Web Subscription Details
Arkansas, the first state to establish the conservative private-plan model for expanding Medicaid under the Patient Protection and Affordable Care Act, now is looking to join several other conservative-leaning states in requiring low-income beneficiaries to make monthly contributions to their...
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News
Number of providers facing Stage 2 EHR hurdle puts billions at stake
By Joseph Conn | August 15, 2014 | Basic Web Basic Web Subscription Details
Billions of dollars in federal electronic health-record incentive payments appear to be in jeopardy as hospitals, physicians and other eligible professionals who got an early start on the payment program face a more stringent set of criteria this year, according to a Modern Healthcare analysis of...
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News
Higher expenses gnaw at New York-Presbyterian's margin
By Bob Herman | August 14, 2014 | Basic Web Basic Web Subscription Details
New York-Presbyterian Hospital in Manhattan posted stable surpluses in the first half of 2014, but increased expenses chipped away at the academic medical center's margin.
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