Critical-access hospitals see little growth

By Michael Sandler  |  October 03, 2015

Despite the outcry on Capitol Hill over rural hospital closings, the number of critical-access hospitals in the U.S. grew slightly in the past year, according to Modern Healthcare magazine's annual review of CMS data.

Rehab care reimbursement under renewed fire from OIG

Rehab care reimbursement under renewed fire from OIG

By Melanie Evans  |  October 03, 2015

A majority of frail Medicare patients who enter nursing homes in need of rehabilitation therapy now receive higher-paying intensive therapy before they leave, a major shift from just years ago, despite no evidence that such therapy is needed. The shift makes the rehab arena an attractive target for...

CAD for breast cancer not worth millions CMS spends on it

By Steven Ross Johnson  |  September 28, 2015

Computer-aided detection for breast cancer screening is no better at identifying the disease ​​than mammograms without the high-tech tool​​, a JAMA study finds. A related editorial urges the CMS to reconsider covering the procedure, which costs Medicare $300 million annually.

Blog: Is 'value-based care' more than a marketing slogan?

By Bob Herman  |  September 24, 2015

The U.S. healthcare system is investing a lot of time, energy and money into the concept of value-based care, and a fascinating commentary in the New England Journal of Medicine hits that idea squarely in the gut.

Judge tells HHS to revisit two-midnight rule's inpatient pay cut

By Lisa Schencker  |  September 22, 2015

A federal judge handed hospitals a partial win Monday when he ruled the HHS secretary must provide better justification for the part of the much maligned two-midnight rule that would cut inpatient payments to hospitals. The judge also ordered HHS to re-open that part of the rule to comments.

A Medicare tourniquet: How hospitals try to heal cuts that bleed away profits

By Jay Greene, Crain's Detroit Business  |  September 20, 2015

Until 2012, before the Affordable Care Act began cutting revenue, most tax-exempt hospitals in Southeast Michigan made profits on their Medicare business. Since then, reimbursement cuts, readmissions penalties and overpayment recoveries have eroded profits for many Detroit-area hospitals and health...

Telehealth expansion needs payment, coverage policy advances

Telehealth expansion needs payment, coverage policy advances

By Dr. Nabil El Sanadi  |  September 12, 2015

Like many industries, healthcare is at a crossroads. One critical decision facing practitioners, especially those of us who operate major healthcare systems, is whether to invest more in our bricks-and-mortar operations or increase funding for cutting-edge telehealth information technology...

Investors hope to profit from sharing Medicare bundled payment load

By Melanie Evans  |  September 12, 2015

The Affordable Care Act's experiments in Medicare payment reform have their doubters, but investors see opportunity. Several companies have emerged to capitalize on the ACA's complex new programs designed to change how traditional Medicare spends more than $450 billion a year in payments.

Closer provider-insurer ties bring new challenges

Closer provider-insurer ties bring new challenges

By Joseph Conn  |  August 15, 2015

Increased collaboration between providers and payers is inevitable, but that doesn't mean the future financial interests of these oft-warring parties will align, say healthcare leaders surveyed in Modern Healthcare's third-quarter CEO Power Panel poll.

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