Utilization news and information

The CMS and Medicare beneficiaries could have saved an estimated $510 million on drugs used to treat end-stage renal disease in 2011 if the reimbursement rate more accurately reflected current usage of these drugs, according to a report from HHS' inspector general's office.
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New Medicaid research that garnered widespread attention from national health policy experts has not yet affected the expansion debate at the state level, but it could bolster national policy changes in the program.
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HHS' inspector general's office is launching an in-depth investigation into cases where Medicare hospice beneficiaries get inpatient care, following unusual billing patterns that surfaced during recent research on the $1.1 billion industry.
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Vanguard Health Systems knocked $12 million off the top end of its forecast for its current fiscal year after tallying lackluster earnings for the quarter ended March 31.
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As insurers prepare to submit 2014 premium rates to state regulators next month, some stakeholders are questioning whether the Patient Protection and Affordable Care Act will be affordable after all.
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Private insurers in the U.S. last year paid significantly more—up to 25 times as much in one case—for common procedures, hospital and doctor visits and prescriptions when compared with private and public insurers in 10 other countries, a report shows.
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Momentum is building among House leaders to draft and introduce legislation this year that would repeal Medicare's troublesome sustainable growth-rate formula used to pay physicians, but upcoming budget battles could thwart those efforts.
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When done right, telehealth programs work. That's the bottom line from a 10-page report, “Scaling Telehealth Programs: Lessons from Early Adopters,” by the Commonwealth Fund. It focuses on three pioneers of home health monitoring technologies and programs: the Veterans Affairs...
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The Cleveland Clinic is the latest hospital system to form a joint venture that aims to address the rising costs of hip and knee implants, stents and other pricey physician preference items.
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Dialysis and kidney-care providers are taking issue with a GAO report released this month that found the government may be over-paying for end-stage renal disease treatment.
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