Medicare

How are Hospitals Making Up for Reimbursement Shortfalls?

November 1, 2013
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How does your organization make up for reimbursement shortfalls? Do you compensate for these shortfalls by shifting the cost of government insurance and uncompensated care to the privately insured? This is what conventional wisdom has said is the best strategy for the longest time, Steve Jacob of DHealthcare Daily writes. However, two recent studies have […]

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Molina Healthcare, Inc.: Terry P. Bayer, J.D., M.P.H., Chief Operating Officer, and Gloria Calderon, Vice President of Molina Medical Group

October 11, 2013
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Thirty years ago, Molina Healthcare was founded by a gentleman with the foresight to know that providing financially vulnerable patient populations with care in the emergency room would ultimately tax the healthcare system to the point of breaking. To reach out to this population, many of whom were uninsured, non-English speaking, and dependent on government […]

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Trend: Primary Care Physicians are Accepting More Medicare Patients than Before

August 27, 2013
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Here’s one of those trends for which the long-term implication can be difficult to decipher. According to Kelly Kennedy in USA Today, physicians are actually accepting more Medicare patients now than in previous years. This, in spite of the fact that 9,500 physicians opted out of Medicare in 2012 compared to 3,700 in 2009, a […]

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Senior Whole Health: Wayne Lowell, Chief Executive Officer

July 24, 2013
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Rising healthcare costs, particularly in light of an aging population, is a challenge for healthcare and government leaders in the United States. One company in Massachusetts, however, is working to provide total care for seniors receiving Medicare and Medicaid benefits. Focusing on wellness to save money Senior Whole Health provides a healthcare plan for dual-eligibles, […]

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Price Transparency Becoming More Vital for Hospitals (Part 2 of 2): The Local Unveiling

May 23, 2013

Steve Sonenreich, chief executive of Mount Sinai Medical Center in Miami Beach, scored several points for price-transparency advocates when he “made a public pledge Monday to divulge the contractual rates the hospital charges private insurers for diagnoses and treatments,” Daniel Chang reports for The Miami Herald. Sonenreich’ announcement comes “in the wake of last week’s […]

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Moody’s Testing New Value-Based Indicators for Hospitals

May 16, 2013

In the new era of value-based healthcare, what indicators are going to be used to evaluate hospitals, especially since value is less quantifiable than volume? According to John Commins at HealthLeaders Media, Moody’s Investor Service is experimenting with 20 new indicators for rating hospitals. Moody’s believes these indicators will “focus on value and measuring demand […]

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Maryland Health Officials Seek Sweeping Changes in Hospital Reimbursements

April 2, 2013

Maryland health officials are suggesting drastic measures to reform its hospital payment system. Last week, they submitted to CMS changes that can only be described as sweeping. As the Associated Press reports, these changes are “the most significant in 40 years” for the state, with the goal being to keep Maryland’s “unique Medicare waiver agreement […]

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ACO Pioneers Request Delay on Quality Penalties and Rewards

March 12, 2013

When the Obama Administration first began its roll-out of the PPACA, it wanted to test the key tenet of its cost-control goals: the ACO model, under which doctors are paid for quality value not patient volume. As Sarah Kliff notes at The Washington Post’s Wonkblog, 32 healthcare systems, known as the Pioneers, agreed to test-run […]

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Medicare Patient 30-Day Readmission Rates Fell in 2012

March 4, 2013

Healthcare executives across the country have been frustrated with their 30-day patient-readmission rates, especially among Medicare recipients. For five years or so, it seemed like nothing could be done to keep these rates from increasing. However, 2012 might have been a turning point, according to CMS. As Stephanie Armour reports for Bloomberg, “Thirty-day readmission rates […]

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Sequestration Cuts a Better Alternative for Providers

February 28, 2013

Washington, D.C.’s latest episode of The Blame Game, sequestration, reaches it anticlimax tomorrow, and with it, $85 billion in automatic cuts will be made to the federal budget. Among these cuts, the Associated Press reports, is 2 percent in Medicare. However, those who will be affected, such as hospitals and doctors, aren’t “raising a ruckus,” […]

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