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North Carolina hospitals and doctors say the state's push to institute Medicaid managed care will reduce services for the poor and shortchange providers despite the legislation giving them the opportunity to bid on the contracts. Late...
Achieving the goals of accountable care—better coordination, improved outcomes, lower costs—requires a robust health information technology infrastructure and the ability to analyze large volumes of patient data.  Modern Healthcare...
Section 101 of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) repeals the Medicare sustainable growth rate (SGR) methodology for updates to the physician fee schedule (PFS) and replaces it with a new Merit-based Incentive...
The Senate passed legislation on Thursday intended to protect small and midsize businesses from increases in health insurancepremiums, clearing the bill for President Obama’s expected signature. The action by Congress was a rare example...
The federal government is asking physicians whether their Medicare reimbursement should hinge in part on accepting new Medicaid patients or participating in provider networks of health plans offered through Affordable Care Act (ACA)...
FOR IMMEDIATE RELEASE September 29, 2015 HHS announces $685 million to support clinicians delivering high quality, patient-centered care Health and Human Services Secretary Sylvia M. Burwell today announced $685 million in awards to 39...
WASHINGTON DC – The Patient-Centered Primary Care Collaborative (PCPCC) is one of 39 health care collaborative networks selected to participate in the Transforming Clinical Practice Initiative, announced today by Health and Human Services...
The CMS Innovation Center is awarding $685 million to more than three dozen physician groups, health systems and other organizations for training, education and investment in information technology, care coordination and quality-...
Today, almost 60 million Americans are covered by Medicare — and 10,000 become eligible for Medicare every day. For many years, Medicare was primarily a pure fee-for-service (FFS) payment system that paid health care providers based on...
Maintaining the staffing and care coordination requirements of the patient-centered medical home (PCMH) costs an average of $8600 per month, and even partial implementation of PCMH features can cost approximately $105,000 per full-time...
Twenty-six percent of the 353 MSSP and Pioneer ACOs qualified for shared savings nationwide in performance year 2014, according to CMS. Nearly half (47%) of the MSSP and Pioneer ACOs in Premier's PACT collaborative qualified in the same...
The CMS' Pioneer accountable care organizations are reducing the number of services they provide to patients that have minimal clinical benefit, a study in JAMA Internal Medicine found. The results suggest that the ACO program is having...
As healthcare organizations sit down to plan their operational strategies for the next few years, they may find themselves staring into a maelstrom of uncertainty, rapid evolution, and unpredictable change.  With the timing of the EHR...
Los Angeles County’s Department of Health Services is betting it can save money while radically improving the health of some of its sickest and most challenging patients. Last March, county health officials began targeting individuals in...
Primary care physicians spend a good many practice hours caring for patients with multiple medical conditions. Family physicians, in particular, are experts at coordinating the care of so-called complex patients. But the term "complex"...
Sylvia Burwell, Secretary of Health and Human Services, recently announced the department’s intention to tie most Medicare fee-for-service payments to value by 2018. Most commercial insurers already incentivize quality to some degree and...
Most family physicians likely have wondered at the end of a particularly frustrating day why certain technologies or systems -- say, for instance, electronic health records (EHRs) -- that were created with the best of intentions to make...
Ask Anthony Stavola, M.D., how adopting the patient-centered medical home model has changed the way he practices medicine, and he’ll answer with a personal anecdote. It involves a patient with newly diagnosed type 2 diabetes and a...
Horizon Blue Cross Blue Shield of New Jersey, along with several of New Jersey's leading health systems and a major multispecialty physician group announced today that they have formed a unique, first-of-its-kind statewide alliance. The...
Expectations were high that accountable care organizations (ACOs) could generate significant savings to Medicare, and the latest report from CMS(www.cms.gov) on their 2014 performance illustrates gradual but continued savings. The 20 ACOs...

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