One of the main ways the Affordable Care Act seeks to reduce health care costs is by encouraging doctors, hospitals and other health care providers to form networks that coordinate patient care and become eligible for bonuses when they deliver that care more efficiently. The law takes a carrot-and-stick approach by encouraging the formation of […]
Dr. Atul Gawande has done it again. Writing in the New Yorker, Gawande, a general surgeon at Brigham and Women’s Hospital in Boston, author and MacArthur Foundation “genius grant” recipient, painstakingly explains the “epidemic of unnecessary care” that bears much of the blame for the country’s runaway healthcare costs and preventable deaths. Gawande also looked […]
If you’re helping clients navigate big changes—from the surge in GLP-1 demand to AI to the growing pressure to demonstrate ROI – we want your thoughts.
It's someone who shares little risk or liability. I wonder: is this right?
Even though Obamacare called for more coverage for women's health, payers have not stepped up.
A look at how insurance companies operating in Tennessee will be altered by these reforms give a window to the bigger Medicaid managed care changes.
Attrition has been high in Medicare’s Pioneer Accountable Care Organization program, as only 19 of the 32 original participants remained after two years. For those that stuck it out, results have been mixed. In March, the Centers for Medicare and Medicaid Services introduced the Next Generation ACO model, said to build on the experience of the […]
See how Quantum Health is providing the steps to help their members tackle the cost of specialty medications and other drugs.
St. Joseph Hospital in Nashua, N.H., is making its first foray into accountable care not because of a risk-based contract with an outside payer, but because it self-insures employees, and thus was already at financial risk for the health of many of its patients.
TOP STORIES Did you expect a Morning Read full of HIMSS coverage? Well, the conference is so large MedCity News is dedicating a separate e-newsletter to all of our coverage. You’ll also see a Morning Read-style wrap up of HIMSS-only news published Monday through Thursday (it will appear on the site about an hour after […]
Robert H. Wagner, director of revenue cycle at Methodist Health System, shares how his hospital found a way to tell patients ahead of time how much they were going to owe and how that got patients to pay them more often. The method, he said at the Revenue Cycle Solutions Summit at HIMSS 2015, put the hospital and the patient "on the same team."
Get a tour of the recently opened America's Health Insurance Plans innovation center. The group will use it to collaborate and test new ideas on topics including healthcare and wellness. AHIP describes it as an "action hub" where all of healthcare can collaborate on creative solutions to specific problems. It's based in Chicago.
Choosing the right software translates directly into better client management, operational efficiency and growth for your spa franchise. Discover which tool is best for your business.
I recently sat in a conference room with an executive of a major health plan located on the East Coast. He made a statement that illustrates the perspective of payers across the country: “We [as payers] are uniquely positioned to see all the care activities around an individual member. Yet, we struggle in our ability […]
CMS yesterday unveiled a new model for ACOs as part of an attempt to make such coordinated care organizations more predictable and enticing for providers, and with that will come increased coverage of telehealth services. According to the American Telemedicine Association, the development is no small deal. “The decision is particularly significant because under this new model, […]
This is a refreshing sentence: We have another entrant in the increasingly crowded health transparency space. The non-profit Health Care Cost Institute today unveiled Guroo.com, which the group says provides some the most accurate estimates for medical procedures on the web. Institute Executive Director David Newman stated a site like Guroo could help the growing […]
UnitedHealth today unveiled a series of interesting upgrades to its Health4Me app, including mobile payments and integration into wearables. It’s yet another expansion of the app, which until the middle of last year was for members only. In July, UnitedHealthcare opened it to anyone who wanted to check healthcare pricing. This moved Health4Me into the […]
As the health law’s second open enrollment season barrels to a close on Sunday, nearly a million Texans have purchased or applied for health insurance. This time around, insurance brokers are aggressively marketing themselves to shoppers – it’s a big change for the brokers who have had an uneasy relationship with the health law for […]