Hospitals & Providers

Keeping patients in the hospital one day longer can significantly reduce readmissions, save costs, and save patients’ lives, according to a new study by the Columbia Business School.

Texas-based Memorial Hermann Health System and the Memorial Hermann Physician Network launched a co-branded health plan in a quest to operate more efficiently and grow market share.

At a time when insurers are expanding their presence on state exchanges and rolling out tech-savvy portals to capture new customers, single state “Blue” insurers are finding themselves hamstrung by regulations and lack of capital.

A patient-centric approach to pre-admission testing can reduce costs and help hospitals run more efficiently.

The rate of hospital readmissions has been declining following the the launch of the Hospital Readmissions Reduction Program (HRRP) in 2012

The Affordable Care Act has migrated risk for the discharge process from payers to providers, making effective discharge planning essential.

With outcomes increasingly tied to reimbursement rates, hospitals and physicians have to work together to achieve goals.

As of January 1, 2015, the U.S. Centers for Medicare and Medicaid will only be awarding payments to MA plans that receive 4 stars or higher.

A record number of hospitals are being fined a total of $428 million by Medicare for excessive readmissions.

Hospitals will save $5.7 billion this year in uncompensated care costs due to the implementation of the Affordable Care Act (ACA), according to a new report by the U.S. Department of Health and Human Services (HHS).

CMS recently issued quality and financial performance results showing that Medicare ACOs have improved patient care and produced hundreds of millions of dollars in savings for the program. But when the numbers are broken down, only half of the ACOs in the two programs saw any return on investment.

Consumer base more invested, engageable

The National Committee for Quality Assurance (NCQA) released new technical specifications for the 2015 edition of the Healthcare Effectiveness Data and Information Set (HEDIS).

4 strategies to follow for successful performance in diagnostic imaging

Behind the political issues and the deep emotions is the reality that the United States must overhaul end-of-life care

Experts say directly comparing ACO models can be difficult because stakeholders often take different approaches to care management

Terminally ill patients and their families often want to know to everything about the prognosis

Move from volume to value by fundamentally challenging the status quo

Measures of access to care explained almost half of variation in readmission by county

Massachusetts and Oregon studies show emergency department increases once patients have health insurance coverage

Prepare for a significant increase in self-pay liabilities from the “high-deductible“ patient population or risk a reduced level of reimbursement

Mammograms contribute 62% of the cost and the remaining 38% is attributed to follow-on diagnostics.

Stewardship includes influences of prescribing patterns through guidelines and incentives

A delay for ICD-10 will not delay ICD-11

Their care experience isn’t at the level it should be

Add it up: 3 reasons for the delay; 6 assets affected; 6 reasons for the price tag; and one future mind-boggler

Sebelius says more Latino outreach is needed, meanwhile commercial enrollees are popping up more often

Seattle Children’s Hospital has been publicly at odds with insurers over the trend toward narrow networks.

Health plans should consider turning to their members to ask for quality feedback.

Four key developments to watch for