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Network squeeze: Controversies continue over narrow health plans

By Bob Herman  |  March 28, 2015

Narrow-network health plans have grown in popularity, particularly on the Affordable Care Act's insurance exchanges, because their cheaper premiums appeal to price-sensitive consumers, but there is significant consumer and provider dissatisfaction with how many of these plans are organized.

Demand grows for care coordinators in primary care

By Melanie Evans  |  March 28, 2015

A growing number of health systems, accountable care organizations and medical home-style practices are deploying care coordinators—which some call navigators. That is changing how patients get care and it's changing the jobs of doctors, nurses and other front-line providers.

Future of Medicaid hospital improvement program in doubt

By Virgil Dickson  |  March 28, 2015

It's unclear whether the Obama administration will renew Delivery System Reform Incentive Payment programs in several states, in part because evidence is mixed on whether the programs have truly improved care for large numbers of Medicaid beneficiaries and uninsured patients.

Late News

SGR fix bill also streamlines quality reporting

By Darius Tahir  |  March 28, 2015

The long-awaited sustainable growth-rate fix that passed the House last Thursday and will go to the Senate in mid-April will likely, in addition to instituting a permanent fix for the SGR, simplify quality reporting requirements for providers.

FDA worries 21st Century Cures Act may compromise safety

By Virgil Dickson  |  March 28, 2015

Outgoing Food and Drug Administration Commissioner Dr. Margaret Hamburg, in what was likely her final public address as commissioner last Friday, raised serious concerns about possible patient harm that could occur as the result of the 21st Century Cures Act now circulating on Capitol Hill.

The Week Ahead

Prominent ACA experts to debate reform law's success

By Lisa Schencker  |  March 28, 2015

Two prominent voices in the debate over the legality of premium subsidies will go head to head Wednesday on the question of whether healthcare reform is succeeding, five years after the Affordable Care Act was signed into law.

Regional News

Intermountain Healthcare's finances had big gains in 2014

By Bob Herman  |  March 28, 2015

SelectHealth, the health insurance division of Intermountain Healthcare, closed 2014 with a sizable top-line gain after it added thousands of members to its growing lineup of benefit options.

Maryland hospitals make big patient-safety improvements

By Sabriya Rice  |  March 28, 2015

Hospitals in Maryland are seeing impressive progress in reducing readmission rates and preventing patient harm from hospital-acquired infections, medication errors and other safety events, according to a report released last week by the state's hospital association.

Cleveland Clinic, Piedmont create cardiac-care alliance

By Adam Rubenfire  |  March 28, 2015

The Cleveland Clinic has agreed to a cardiovascular-care alliance with Atlanta-based Piedmont Healthcare. Clinical policies, treatment protocols and research opportunities will be shared between the clinic and the Piedmont Heart Institute.

News

Hopes run high for passing doc fix when Senate returns in April

By Paul Demko  |  March 28, 2015

The fix isn't in yet, but it's close. The Senate adjourned for its spring break Friday without taking action on legislation permanently repealing and replacing Medicare's sustainable growth-rate physician-payment formula.

GOP hopes budget will lead to replacing ACA

By Paul Demko  |  March 28, 2015

With their late-night vote last week, Senate Republicans have joined their House counterparts in passing budget blueprints that set the stage for a fierce battle with the White House over the shape of the nation's healthcare system and appropriate levels of taxation and spending.

Tenet's Baylor deal builds network strategy

By Beth Kutscher  |  March 28, 2015

Tenet Healthcare Corp.'s partnership last week with not-for-profit Baylor Scott & White Health is the latest example of the chain's departure from the traditional mergers-and-acquisitions playbook in favor of forming regional networks and positioning itself for broader payment reform.

Questions mount on VA cost overruns, delays

By Andis Robeznieks  |  March 28, 2015

“Good riddance.” That was the two-word statement issued by U.S. Rep. Jared Polis (D-Colo.) on hearing the news that Glenn Haggstrom, the Veterans Affairs Department chief of acquisition, logistics and construction, had resigned last week.

Feds propose tougher look at whether EHRs work

By Darius Tahir  |  March 28, 2015

The federal health information technology coordinator's proposed certification rule signals that the agency wants to better ensure that electronic health-record systems perform as promised.

Cover Story

Network squeeze: Controversies continue over narrow health plans

By Bob Herman  |  March 28, 2015

Narrow-network health plans have grown in popularity, particularly on the Affordable Care Act's insurance exchanges, because their cheaper premiums appeal to price-sensitive consumers, but there is significant consumer and provider dissatisfaction with how many of these plans are organized.

Features

Demand grows for care coordinators in primary care

By Melanie Evans  |  March 28, 2015

A growing number of health systems, accountable care organizations and medical home-style practices are deploying care coordinators—which some call navigators. That is changing how patients get care and it's changing the jobs of doctors, nurses and other front-line providers.

Future of Medicaid hospital improvement program in doubt

By Virgil Dickson  |  March 28, 2015

It's unclear whether the Obama administration will renew Delivery System Reform Incentive Payment programs in several states, in part because evidence is mixed on whether the programs have truly improved care for large numbers of Medicaid beneficiaries and uninsured patients.

Editorial

The SGR fix helps the value-based care evolution

By Merrill Goozner  |  March 28, 2015

The incentives in the permanent “doc-fix” legislation, which now has overwhelming bipartisan support from both houses of Congress and the president, will not, by themselves, drive physicians toward value-based compensation schemes.

Guest Commentary

Two ways to make ACOs work better

By Dr. Elliott Fisher, Judd Gregg and Dr. James Weinstein  |  March 28, 2015

New payment models adopted by Medicare and many health plans have clearly led to better care for patients. They also might be helping to slow the overall growth of healthcare spending.

Letters

Osteopathic students have multiple chances for a match, and other letters

By Modern Healthcare  |  March 28, 2015

Regarding the article “Medical grads, seniors learn where they're going in record Match Day”, while appreciating the coverage of this important day in the lives of future physicians, the American Association of Colleges of Osteopathic Medicine must take this opportunity to correct an...

Best Practices

VA hospital reduces worker injuries from moving patients

By Maureen McKinney  |  March 28, 2015

Despite ample research showing the benefits of using mechanical patient-handling equipment such as overhead lifts, workers at many hospitals and nursing homes still are hoisting and moving patients the old-fashioned way. But that isn't true at the VA Loma Linda (Calif.) Healthcare System.

Q&A

Insurers don't want to share savings from reduced utilization

By Modern Healthcare  |  March 28, 2015

Modern Healthcare recently spoke with Dan Wolterman, president and CEO of Houston-based Memorial Hermann Healthcare System, about accountable care, tensions with insurers over starting a health insurance arm, and Memorial Hermann's shift to outpatient care.

By the Numbers

Physician staffing firms expect solid growth

By Michael Sandler  |  March 28, 2015

Physician staffing firms will reap the benefits of the nation's economic recovery, Medicare physician payment reform and the Affordable Care Act coverage expansions, experts say.

23 Largest Physician Staffing Firms in 2015

March 28, 2015

A list of the nation's 23 largest physician staffing firms ranked by number of physician recruiters as of March 2015. Sources: NAPR, and Modern Healthcare reporting. Published March 30, 2015, p. 34.

News Makers

Bruce retiring as CEO at Presence Health

By Modern Healthcare  |  March 28, 2015

Sandra Bruce will retire as president and CEO of Presence Health, roles she has held since the Chicago-based system was created through the November 2011 merger of Provena Health and Resurrection Health Care.

Data Points

Data Points for March 30, 2015

By Modern Healthcare  |  March 28, 2015

Data Points for the week of March 30, 2015, covered the following topics: Medicare, Medicaid, cancer, diabetes, data breaches and uncompensated care

Outliers

Sexually active senior citizens fare better mentally

By Modern Healthcare  |  March 28, 2015

Pucker up seniors ... it may be good for your health. A growing body of research finds that continuing to get your groove on as you age can bear some provocative mind and body benefits.

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