Category: ACO

While it’s clear that the ICD-10 deadline will be pushed back for the second time in nearly two years thanks to the inclusion of a delay in the latest sustainable growth rate patch legislation, what’s not so clear is what comes next for both providers and payers. In a pair of recent posts, Deloitte Healthcare…

Today’s headlines include news and analysis about the 7 million insurance enrollment tally. Reporting for Kaiser Health News, in partnership with NPR, Eric Whitney writes: “The names of the big health insurance companies are familiar – Blue Cross, Aetna, United Healthcare. But what about CoOportunity Health, or Health Republic Insurance of New York? These are…

The past six months have been really amazing here at Healthcare Scene. In October, we acquired Healthcare IT Central and associated health IT career resources and next week we’ll be hosting the first ever Health IT Marketing and PR Conference. While these are two major milestones for Healthcare Scene, we’re not stopping there. We have…

One of the biggest challenges facing hospital financial executives is formulating a self-pay revenue cycle strategy. This is particularly true given the far-reaching effects of the Affordable Care Act. The self-pay patient population has changed. Although fewer patients are now uninsured, high deductibles and other out-of-pocket expenses leave hospitals with rising self-pay receivables. …read more    

Magellan Health Services, Inc. today announced that it has entered into an agreement to acquire CDMI, LLC, a privately-held company that provides a range of clinical consulting programs and negotiates and administers drug rebates for managed care organizations (MCO) and other customers. …read more    

I’ve been openly bullish on ACOs and capitated payment models. The only way to achieve the triple aim – quality, cost and access – is to create a system that is structurally incentivized towards those ends. The fee-for-service model will never be structured in a way that incentivizes the triple aim. On the other hand,…

Waco Surgical Group had been performing billing in-house since 1952, and its staff was certain that no third party could do it better. Then its team realized the need to explore options due to two events: the looming transition to ICD-10 and its nearly 69,000 new billing codes, and the decision of long-time business office…

One by one, the myths of the Affordable Care Act have been revealed. When the curtain on open enrollment falls on March 31, the last remaining big myth of ObamaCare will be fully exposed: The individual mandate has failed. After a last-ditch effort with President Obama himself encouraging “young invincibles” to sign up before the…

The Affordable Care Act returned to the Supreme Court on Tuesday, as the Justices heard a major challenge to the law’s birth-control mandate. Five and maybe even six Justices across ideological lines seemed discomfited by the Administration’s cramped conception of religious liberty (3/25). …read more    

The Intensive Care Unit at The Miriam Hospital has attained a silver-level Beacon Award for Excellence from The American Association of Critical-Care Nurses. The three-year award recognizes the hospital for its exceptional patient care and improved patient outcomes, and practices that follow the AACN’s six Healthy Work Environment Standards. …read more