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Care Delivery

 

Judging by 28 different metrics, Vermont offers the highest-quality and most cost-efficient care for children, according to a new study from personal finance website WalletHub, while Nevada struggles with limited access to care and poor oral health among those under the age of 18. 

The effectiveness of accountable care organizations (ACOs) may be limited by two factors, according to a new study published in Health Affairs: low numbers of enrollees attributed to participating physicians and the constant “churn” of the patient population caused by substantial physician turnover.

An emergency physician from Michigan has been arrested on charges she performed genital mutilation procedures on multiple girls between the ages of 6 and 8, which prosecutors say could be the first criminal case involving the practice since it was outlawed in the U.S. in 1996.

While healthcare costs continued to rise at other facilities, one Netherlands hospital was able to lower costs by 8 percent in a single year while improving quality. The credit goes to a value-based care strategy focusing on everything from closer coordination on cardiovascular patients to keeping more experienced physicians in the emergency department. 

Large corporations want healthy workers and lower healthcare costs. If hospitals and medical groups are going to win the right to provide care to those employees and their families, innovative approaches to care, having the right infrastructure in place and taking a lot of meetings are a must. 

 

Recent Headlines

Telehealth increases utilization instead of replacing office visits

Using direct-to-consumer telehealth, where a patient was direct access to a physician on the phone or through videoconferencing, may be a tool to increase access to care. According to a study published in the March 2017 issue of Health Affairs, it also increases utilization and spending. 

Need for real-world evidence in value-based care could be advantage for pharma

With more physicians employed in larger organizations than private practices, and those larger groups being more likely to be reimbursed through models which involve financial risk, more physicians are looking to real-world evidence to inform their clinical decisions—a shift which could be beneficial for pharmaceutical companies.

New Jersey law limits initial opioid prescriptions to five days

New Jersey has enacted what its governor calls the strictest anti-opioid law in the country, affecting how long the length of initial prescriptions and waiving prior authorization requirements for those seeking treatment for addiction.

Uninsured rate at 8.8 percent; high-deductible plans on the rise

The latest National Health Interview Survey figures on health coverage show the number of people without health insurance fell to a new low through the first nine months of 2016.

California insurers reported inaccurate provider info to regulators

According to a review released by the California Department of Managed Health Care (DMHC), 90 percent of California insurer reports on which providers were in their network contained inaccurate information.

Lower wages change utilization, even in employer-sponsored insurance plans

Workers who make $24,000 or less annually, but still have employer-sponsored health insurance, have higher hospital and emergency department admissions rates and lower utilization of preventive care compared to higher-paid coworkers.

Physicians warn Trump immigration order will worsen doctor shortage, affect care

Two University of Pennsylvania Medical Center physicians said suspending immigration from seven Muslim-majority countries will have a negative impact on graduate medical education (GME) and the U.S. healthcare system as a whole.

Major organizations aim to change prior authorization requirements

A coalition of medical organizations led by the American Medical Association has released a 21-point plan to change when health insurers require pre-approval before patients can receive certain treatments, drugs or devices.

Illinois governor proposing new pharmacy rules after risky drug combinations go unnoticed

In response to a Chicago Tribune investigation, Illinois Gov. Bruce Rauner is a backing of series of changes to the state’s oversight of pharmacies, including sending “mystery shoppers” to make sure pharmacists are warning customers when their prescriptions may have adverse effects when taken together. 

Anthem ending opioid treatment preauthorization nationwide

Anthem has reached a settlement with New York Attorney General Eric Schneiderman to end its policy requiring prior authorization for medication-assisted treatment (MAT) for opioid addiction.

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