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Medicaid plans struggle to provide mental health services

By Virgil Dickson  |  July 04, 2015

As low state reimbursement rates drive mental health providers away from Medicaid, managed-care plans taking over some state programs are looking for creative ways to deliver a service that many see as key to holding down overall costs.

Late News
The Week Ahead

Calif. Senate considers cap on out-of-pocket drug costs

By Virgil Dickson  |  July 04, 2015

A bill to cap patients' out-of-pocket costs for prescription drugs that passed the California State Assembly will be considered by the state Senate this month, as policymakers across the country wrestle with the growing problem of unaffordable drugs.

FDA decisions expected on pricey new cholesterol drugs

By Steven Ross Johnson  |  July 04, 2015

The Food and Drug Administration may issue approval decisions this month and next for two cholesterol-lowering drugs that could drive the nation's drug costs even higher.

Regional News

Mass. lawmakers discuss behavioral healthcare crisis

By Andis Robeznieks  |  July 04, 2015

Lawmakers in Massachusetts are debating bills that seek to reduce boarding of behavioral health patients in hospital emergency departments and to keep them from being housed in correctional facilities.

Illinois budget battle clouds mental-healthcare merger

By Adam Rubenfire  |  July 04, 2015

Nashville-based behavioral healthcare provider Centerstone has completed its merger with WellSpring Resources, a mental-health provider based in Alton, Ill., but leaders are concerned that the newly combined business will be affected by a protracted budget battle in the Illinois Legislature.

News

Dialysis pay-for-performance looms

By Sabriya Rice  |  July 04, 2015

In an effort to improve outcomes at the nation's 6,000 dialysis facilities, Medicare plans to cut reimbursement rates up to 2% if the facilities perform poorly on an expanded set of quality metrics.

Building protocols into EHRs can help cut wasteful care

By Melanie Evans  |  July 04, 2015

MRIs, CT scans and X-rays for low back pain patients dropped by half last year at the UPMC health system in Pittsburgh after doctors started seeing reminders in the electronic health record that such tests can be unnecessary, a move inspired in part by the Choosing Wisely campaign.

Obama speech kicks off new drive to expand Medicaid

By Beth Kutscher  |  July 04, 2015

With the Affordable Care Act's premium subsidies protected for now, the Obama administration and the hospital industry are stepping up their efforts to persuade the 21 holdout states to expand Medicaid to low-income adults.

Data show Genentech paid the most to providers

By Art Golab and Michael Sandler  |  July 04, 2015

Genentech, the maker of Avastin and other pricey cancer drugs, paid physicians and teaching hospitals more than any other drug or device company did in 2014, according to data published last week on the CMS' Open Payments website.

Nominees sought for annual Up & Comers awards

By Modern Healthcare  |  July 04, 2015

As healthcare executives continue to face new challenges and encounter new opportunities, the next generation of leadership must evolve along with the changing industry, requiring new ideas and approaches in all sectors. Today's young executives are already proving they are up to the task.

Cover Story
Features

Medicaid plans struggle to provide mental health services

By Virgil Dickson  |  July 04, 2015

As low state reimbursement rates drive mental health providers away from Medicaid, managed-care plans taking over some state programs are looking for creative ways to deliver a service that many see as key to holding down overall costs.

Editorial

Editorial: Save AHRQ; spend more on delivery system R&D

By Merrill Goozner  |  July 04, 2015

For decades, the nation has poured hundreds of billions of dollars into basic and applied science to devise cures for diseases. But investing in research and development for new and better ways of delivering care in hospitals and physician offices remains a stepchild in Washington.

Guest Commentary

Collaboration helps vets with traumatic brain injuries heal

By David Hovda  |  July 04, 2015

Since 2001, nearly 320,000 American soldiers, sailors, airmen and women, Marines and Coast Guard personnel have been diagnosed with traumatic brain injury. But if all works out, by the end of 2016 four new military sites will be providing cutting-edge care for TBI.

Letters
Best Practices

Iowa medical center devises strategy to reduce food waste

By Maureen McKinney  |  July 04, 2015

In 2012, roughly 12% of the food that the University of Iowa Hospitals and Clinics prepared went into the garbage. Faced with that sobering statistic—and a scathing article in a local newspaper about food waste at the hospital—the health system's leaders decided to make serious changes.

Q&A
By the Numbers

Senior housing boom propels healthcare REITs

By Michael Sandler  |  July 04, 2015

A growing pipeline of senior housing construction projects has buoyed growth for the healthcare real estate investment trusts on Modern Healthcare's annual list of the largest healthcare REITs, experts say.

Real estate investment trusts, 2015

July 04, 2015

The 16 largest healthcare real estate investment trusts, ranked by market capitalization as of May 31, 2015. Source: National Association of Real Estate Investment Trusts. Published July 6, 2015, p. 34.

News Makers

Sebelius, Thompson to co-chair new health policy forum

By Modern Healthcare  |  July 04, 2015

Former HHS secretaries Kathleen Sebelius and Tommy Thompson are co-chairs of the newly formed Aspen Health Strategy Group, a forum for healthcare leaders and policymakers to discuss potential solutions to the industry's thorniest issues.

Data Points

Data Points for July 6, 2015

July 04, 2015

Last month, the U.S. Supreme Court upheld the ACA's premium subsidies, most likely saving the law from major changes in the immediate future. But GOP critics still argue that the law is a failure. Here we examine how insurance coverage rates and readmission rates have changed since it took effect.

Outliers

UPMC gets in tiff with local newspaper

By Modern Healthcare  |  July 04, 2015

The crossfire in the feud between the UPMC health system and insurer Highmark has hit another party—hometown newspaper the Pittsburgh Post-Gazette.

Putting placebos to the test in plain sight

By Modern Healthcare  |  July 04, 2015

The power of placebos is well-known. But placebos are now being tested as an actual treatment for a very real disorder—the crushing fatigue that often follows cancer treatment, even years later. And the participants will know they're taking placebos.

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