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When Medicaid expansion came to Louisville, Ky., it created an opportunity for a population traditionally served by public health clinics to receive healthcare through a wholly different mechanism -- and so far that mechanism appears to be...
Health care policy experts have cautioned that making the transition away from a fee-for-service payment model will be a marathon, not a sprint, yet one accountable care organization (ACO) in Florida has moved quickly out of the gate. ...
The politics of Medicaid are robust and complicated.  However, the complexity of the issue shouldn’t prevent Medicaid patients from receiving timely and quality health care services – especially primary care.  Supporting access to...
After passing both houses of Congress with overwhelming support, legislation designed to increase medical access for military veterans who are struggling to obtain basic health care at U.S. Department of Veterans Affairs (VA) facilities...
It is well recognized across the health care industry that the major goals of the Affordable Care Act (ACA) include not only expanding health insurance coverage, but also improving the quality of care and the patient health care experience...
The patient-centered medical home (PCMH), introduced in 2007, is a model of health care that emphasizes personal relationships, team delivery of care, coordination across specialties and care settings, quality and safety improvement, and...
Just six states will use their own money in 2015 to sustain the federal Medicaid pay raise to primary care doctors, which was a key provision of the Affordable Care Act intended to make sure millions of low-income people enrolling in the...
Just six states and the District of Columbia will use their own money in 2015 to sustain the federal Medicaid pay raise to primary care doctors, which was a key provision of the Affordable Care Act intended to make sure millions of low-...
Accountable care organizations (ACOs) and value-based purchasing arrangements will be responsible for the care of 130 million patients by 2017, predicts a report by Parks Associates.  Accountable care will generate nearly $1 billion in...
Payment reform in health care is confusing, but the goal is simple: How can health care providers change their economic incentives to encourage value over volume? If you've wondered about how these new payment models work, we’re here to...
New study findings released today confirm that Horizon Blue Cross Blue Shield of New Jersey’s patient-centered program is working to improve the coordination of care and lower costs. The 2013 patient-centered study is the largest to date...
Clinician adoption and implementation of health information technology (IT) has increased significantly since the passage of the HITECH Act in 2009. Dedicated efforts and large financial incentives have spurred innovation and motivated...
Dr. Bruce Bagley is president and CEO of TransforMED, a wholly owned subsidiary of the American Academy of Family Physicians, which provides guidance and support to physicians implementing patient-centered medical homes. Bagley, a family...
For value-based payment programs to succeed, insurers must provide incentives for providers that involve more than financial rewards. That's because a wide range of factors, including intrinsic motivation and medical professionalism,...
By combining forces, solo and small-group medical practices helped generate $237 million in savings over three years in CareFirst's Patient-Centered Medical Home Program, the insurer revealed Thursday. CareFirst, a Blue Cross and Blue...
In one of the largest tests of a novel way to deliver and pay for healthcare, insurer CareFirst BlueCross BlueShield announced on Thursday that 1.1 million people receiving care through its "patient-centered medical homes" last year were...
A few years ago it struck the D.C. region’s biggest medical insurer that the doctors who saw its members most often and knew them best got the smallest piece of the healthcare dollar. CareFirst BlueCross BlueShield spent billions on...
Efforts to "bend the curve" in national health spending are likely to be strengthened by the kind of results released by CareFirst's Blue Cross Blue Shield plan last week. The insurer said its patient centered medical home program was...
Health insurers are experimenting with new formulas for reimbursing doctors and hospitals, slowly moving away from the traditional approach of basing payments on the numbers of tests and procedures performed, according to a survey of Blue...
In the latest blow to fee-for-service medicine, the nation’s Blue Cross and Blue Shield plans say they are spending more than $65 billion annually — about 20 percent of the medical claim dollars they pay — on “value-based” care that...

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