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Vital Signs
Why one congressman wants to scrap Medicare's hospital appeals deal
By Bob Herman | September 19, 2014
The CMS has been pretty quiet about its Medicare appeals settlement for hospitals, and now a congressman wants the agency to retract the offer altogether.
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Many new Medicaid enrollees in the dark about benefits, MACPAC hears
By Virgil Dickson | September 19, 2014 | Basic Web Basic Web Subscription Details
Newly enrolled Medicaid beneficiaries are receiving little to no guidance from states or managed-care plans regarding the scope of services they're eligible to receive, according to focus group findings prepared for Medicaid and CHIP Payment and Access Commission.
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With Kaiser in sight, Anthem creates new plan with major California hospitals
By Bob Herman | September 17, 2014 | Basic Web Basic Web Subscription Details
Health insurer Anthem Blue Cross and seven competing health systems in Southern California are joining forces to create a new health plan that executives believe will enhance competition in the area while reducing healthcare costs.
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Medicare ACOs improve quality, have mixed results on slowing spending, CMS says
By Melanie Evans | September 16, 2014 | Basic Web Basic Web Subscription Details
The participants in Medicare's programs for accountable care organizations have continued to produce mixed results. Quality broadly improved but savings proved more elusive among the early participants.
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Vital Signs
Some providers already taking Medicare's RAC appeal deal
By Bob Herman | September 11, 2014
It's been about two weeks since the CMS told hospitals and health systems it would pay a portion of appealed inpatient-status claims, and at least a few have taken Medicare up on its offer.
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CMS questioned on easing impact of tax credits on consumers
By Virgil Dickson | September 10, 2014 | Basic Web Basic Web Subscription Details
With the 2015 tax filing season kicking off in four months, lawmakers grilled senior Internal Revenue Service and CMS officials about what they're doing to make sure millions of Americans who relied on tax credits for health insurance this year won't end up owing the federal government money.
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Reform Update: Using expansion dollars for health plans may be costly, GAO says
By Virgil Dickson | September 09, 2014 | Basic Web Basic Web Subscription Details
Allowing states to use federal Medicaid expansion dollars to buy low-income adults private health plans on the federal insurance exchange may cost the federal government significantly more than if those states simply expanded their traditional Medicaid programs, the Government Accountability Office...
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McAuliffe takes narrower Medicaid path in Virginia after expansion blocked
By Virgil Dickson | September 08, 2014 | Basic Web Basic Web Subscription Details
Terry McAuliffe, Virginia's Democratic governor, has given up on his attempt to expand Medicaid on his own without the support of the GOP-led General Assembly. Instead, he is introducing program improvements for those currently enrolled through an executive order and a series of emergency...
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Reform Update: Increase in Medicaid reimbursement could disappear Dec. 31
By Andis Robeznieks | September 08, 2014 | Basic Web Basic Web Subscription Details
The Patient Protection and Affordable Care Act's provision to temporarily increase Medicaid reimbursement for primary-care services to match Medicare rates has led to a big increase in Ohio physicians accepting new Medicaid patients. But that increase may go away when the ACA primary-care parity...
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Doc-finder Best Doctors buys population-health firm Rise Health
By Darius Tahir | September 03, 2014 | Basic Web Basic Web Subscription Details
Boston-based Best Doctors, which rates and helps consumers find doctors, has acquired population-health-management firm Rise Health for undisclosed terms.
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