Tagged with Healthcare Reform
PA – New Global Capitation Model for Rural Hospitals
CMS has announced a new global capitation model for rural hospitals in Pennsylvania. Under the new model participating critical access hospitals and acute care hospitals will receive all-payer global budgets for a fixed amount of money that is set in advance and funded by all participating insurers, to cover inpatient and outpatient services.
UnitedHealth Group to Buy Outpatient Surgery Chain for $2.3 Billion
UnitedHealth Group has announced plans for its health services unit, Optum, to acquire Surgical Care Affiliates (SCA). Under the acquisition, Optum would add to its footprint SCA 205 surgical facilities, which SCA operates in partnership with thousands of surgeons in 33 states.
Study Finds New Payment Models May Potentially Reduce Health Care Disparities
A new study from Harvard Medical School claiming to have found “meaningful” improvements in quality, outcomes, and spending for all patients in the Alternative Quality Contract (AQC) between suggests binding insurers’ physician payments to quality metrics can narrow disparities between low- and higher-income patients.
CMS Releases Third Innovation Center Report to Congress
As mandated by section 1115A(g) of the Social Security Act, the CMS Innovation Center recently released its third Report to Congress. The report highlights activities between October 1, 2014 and September 30, 2016, but also highlights a number of important activities started during that time period that were announced between September 30, 2016 and December 31, 2016.
ACA Repeal Efforts Begin, while Sign-Ups Continue to Rise
As senate and legislative efforts to repeal the Affordable Care Act (ACA) pick-up, the American Medical Association sent a letter to congressional leaders called on lawmakers to outline plans to replace the ACA before they repeal the law. Despite these efforts, it was recently announced that 8.8 million U.S. residents have signed up for health plans through the federal exchange.
FL – New Law Expands Prescribing Authority to Physician Assistants and Nurse Practitioners
Effective January 1, physician assistants and nurse practitioners practicing in Florida will be allowed to prescribe medications without physician oversight.
NJ – OIG Report Reveals Improper Medicaid Payments
A report released by the HHS Office of Inspector General (OIG) states, over a four-year span, New Jersey has received an estimated $95 million in improper Medicaid payments. According to the report, “The deficiencies occurred because the state … did not adequately monitor [its] partial care services program to ensure that providers complied with [the program’s] requirements.”
NY – New Law Grants Clinicians Access to Patient Data for Minors
New York based clinicians participating in the regional health information organization serving the western part of the state, HEALTHeLINK, are now able to access health data for patients who are between 10 and 17 years old with parents or legal guardians signed consent.
