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January 27, 2015 | Insurance News Net

risk-adjusted base payments can support the move to value

As healthcare reform takes hold across the nation, primary care physicians are preparing for the shift to value-based payment by including risk-adjusted base payment in their payment models. Among other goals, these models aim to cover the...

January 27, 2015 | Modern Healthcare

Hospitals saw fewer admissions, more outpatients in 2013

U.S. hospitals continued to see downward trends in hospital utilization in 2013, and many of them adopted new models of coordinated care that might accommodate the flow of patients to outpatient-care settings. The American Hospital...

January 26, 2015 | Health IT Analytics

CMS: Population Health Management Reduces Admissions, ER Use

Two population health management initiatives that focus on increasing the use of primary care providers have reaped significant results for patients, says CMS Deputy Administrator and Chief Medical Officer Dr. Patrick Conway. The...

January 26, 2015

Statement from the Primary Care Collaborative's (PCPCC) CEO Marci Nielsen on HHS's Announcement to Expand New Medicare Payment Models:

The Patient-Centered Primary Care Collaborative (PCPCC) applauds the U.S. Department of Health and Human Services’ (HHS) goal for 30 percent of Medicare payments to be in alternative payment models by the end of 2016 and 50 percent by the...

January 26, 2015 | Hospitals & Health Networks

Burwell: Tie More Medicare Pay to Quality and Value

HHS Secretary Sylvia Burwell today signaled a seismic leap — at least symbolically — away from traditional fee-for-service health care. In a blog posting, the secretary set an ambitious goal of having 30 percent of traditional Medicare...

January 25, 2015

At 205,000 Strong, The Nurse Practitioner Will See You Now

As the health care workforce shifts to treat patients in less expensive primary care settings, the number of nurse practitioners has nearly doubled in the last decade to more 200,000, new data shows. The American Association of Nurse...

January 23, 2015 | FierceHealthFinance

House debates how to pay for SGR fix

Members of the House Energy and Commerce Subcommittee on Health are working on yet another attempt to reform the unpopular Sustainable Growth Rate (SGR) formula, according to Healthcare Finance News. Healthcare industry groups have long...

January 23, 2015 | Bloomberg

CMS touts promise of two primary care initiatives

Based on first year results, the CMS says its two advanced primary care initiatives show promise for saving money and improving health-care quality. The Centers for Medicare & Medicaid Services in a Jan. 23 blog post said the...

January 22, 2015 | Modern Healthcare

Value-based care not likely to end payer/provider financial spats

A large payer and health system in California are embroiled in a bitter feud over expired contract terms, the type of fight all too common in the fee-for-service world. With healthcare switching to value-based care, some had hoped these...

January 21, 2015 | Washington Post

Millions of children could soon lose their health insurance if Congress doesn’t act

For all the handwringing about what the new Republican-controlled Congress could to do Obamacare, another health insurance program could be dropped entirely if lawmakers don't take action this year: the Children's Health Insurance Program...

January 21, 2015 | Kaiser Health News

Medicaid Pay Hike Opened Doors For Patients, Study Finds

Money talks. A temporary Medicaid pay raise that was part of President Barack Obama’s health law made it easier for poor adults to get appointments with primary care doctors, according to a study published Wednesday. Paying more to...

January 21, 2015 | AAFP News

Public, Private Help Smooth Transition to Medical Home

For some primary care physicians, the idea of transforming a practice into a medical home sounds like a major risk. Yet practices that have made the change in states such as Rhode Island have reported smooth transitions, thanks in part to...

January 19, 2015 | AAFP News

Proposal to Keep Higher Primary Care Pay Heads to Congress: MedPAC Report Will Call for Per-beneficiary Payment, Other Incentives

Members of the Medicare Payment Advisory Commission (MedPAC) voted last week to forestall a 10 percent pay cut for primary care physicians who treat Medicare patients that is slated to take effect next January. Rather than allowing a...

January 17, 2015 | Modern Healthcare

ER visits still rising despite ACA

Patient emergency room visits rose sharply at hospitals with the highest ER use in 2013, the last year before the Affordable Care Act's insurance expansion kicked in, according to Modern Healthcare magazine's latest By The Numbers. And...

January 15, 2015 | PR Newswire

New Primary Care Model Delivers 20 Percent Lower Overall Healthcare Costs, Increases Patient Satisfaction and Delivers Better Care

A review of two years' worth of healthcare claims data on thousands of patients reveals, contrary to the prevailing view, that unlimited primary care drives down overall costs while improving patient outcomes and experience. The analysis...

January 14, 2015 | AAFP News

Practices Making Good Progress on Achieving Care Management Milestones

Halfway through the four-year Comprehensive Primary Care (CPC) initiative(innovation.cms.gov) CMS' Center for Medicare and Medicaid Innovation launched in October 2012, two recent reports shed light on what about 1,300 family physicians ...

January 12, 2015 | Associated Press

Medicare Aims to Improve Coordinating Seniors' Chronic Care

Adjusting medications before someone gets sick enough to visit the doctor. Updating outside specialists so one doctor's prescription doesn't interfere with another's. Starting this month, Medicare will pay primary care doctors a monthly...

January 12, 2015 | Kaiser Health News

Supreme Court Battle Brewing Over Medicaid Fees

Rita Gorenflo’s 7-year-old son Nathaniel was in severe pain from a sinus infection. But since the boy was covered by Medicaid, she couldn’t immediately find a specialist willing to see him. After days of calling, she was finally able to...

January 9, 2015 | Health News Digest

Patient-centered "medical homes" to Increase in 2015

Many doctors' offices across the country have a resolution for the New Year: switching to a team-based model of care called the patient-centered medical home, reports the January 2015 Harvard Health Letter. "It's the highest and best...

January 7, 2015 | Health IT Analytics

Evidence Grows for the Effective Patient-Centered Medical Home: How effective is the patient-centered medical home? A series of studies argue that coordinated care is worth the effort.

The patient-centered medical home (PCMH) has become a widely-used frameworks for a healthcare organization’s transition to value-based accountable care. With its focus on quality, care coordination, preventative services, and chronic...