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Care Delivery

 

The total number of licensed physicians has increased by 12 percent since 2010, with women and Doctors of Osteopathic Medicine (DOs) making up a greater share of the physician population, according to a report released by the Federation of State Medical Boards (FSMB).

Walla Walla General Hospital in Washington has been closed by owner Adventist Health, citing financial challenges and a failed plan to transfer ownership Providence Health & Services.

There appears to be a direct link between hospitals’ initiatives to improve blood use stewardship and a 20 percent decrease in blood utilization for 134 diagnoses which make up 80 percent of red blood cell usage.

Most healthcare organizations with revenue under $1 billion surveyed by the Ernst & Young LLP Advisory Health practice reported having no value-based reimbursement initiatives and placed a lower priority on bundled payments and alternative payment models than larger systems.

States would be able to waive requirements for insurers to cover the Affordable Care Act (ACA)’s “essential health benefits” (EHBs) under Republican plans to replace the law. The benefits most likely to be waived, however, make up small shares of premiums compared to other costs, according to an analysis from Urban Institute fellows Linda Blumberg, PhD, and John Holahan, PhD.

 

Recent Headlines

Estimated ACO numbers up to 520

Consulting firm Oliver Wyman’s ongoing tracking of the growth of accountable care organizations (ACOs) finds an additional 150 such payor-provider arrangements since its last report in July of 2013.

Premier asks CMS for ACO program changes

The structure of the current Medicare Shared Savings Program (MSSP) — the Centers for Medicare and Medicaid Services (CMS) accountable care organization (ACO) trial — has posed challenges for participating organizations, notes the Premier healthcare alliance of 2,900 U.S. hospitals and nearly 100,000 other providers in a letter to CMS Administrator Marilyn Tavenner.

Study finds disjointed care patterns in current Medicare ACO model

Holding organizations accountable for care utilization and outcomes while simultaneously allowing Medicare beneficiaries free access to any provider they want either inside or outside an Accountable Care Organization (ACO) is a problem, say critics of the government’s current ACO program. A new study published by JAMA Internal Medicine finds these critics may be right.

AHA warns that Pioneer ACO program is in danger unless changes are made

Few additional providers will sign up to participate in Medicare’s current Pioneer ACO Model or the Medicare Shared Savings Program unless changes are made to the design of these programs notes the American Hospital Association (AHA) in a letter to the Centers for Medicare and Medicaid Services (CMS) Innovation Center.

Insurer and healthcare provider form unique care coordination joint venture

Insurer Independence Blue Cross (Independence) and integrated care management company DaVita HealthCare Partners have jointly formed a new company, Tandigm Health, to deliver high-quality care at a lower cost in the Philadelphia area, a region with some of the highest healthcare costs in the nation.

Defying expectations, greater insurance coverage is linked to increased ED use

The hope that universal health insurance coverage will move healthcare delivery out of costly care settings like emergency departments (EDs) and into lower-cost primary care settings may not come true unless other barriers to primary care access also are addressed finds a new study.

CareMore, Emory to tackle reducing costs and improving outcomes in Georgia seniors

WellPoint Inc.’s Cerritos, Calif.-based subsidiary CareMore and Atlanta-based Emory Healthcare say they will team up to expand CareMore’s model of care management for Medicare Advantage patients in Georgia.

Hospital groups launch website to improve perception of consolidation

The American Hospital Association and the Federation of American Hospitals have joined forces on changinglandscape.org, a new website that aims to explain how realignment and consolidation of hospital systems can help communities and patients.

Majority of physician practices not joining ACOs

A national telephone survey finds that 60.6 percent of physician organizations report no current involvement and no plans to become involved in an accountable care organization (ACO) in the near future.

NCQA Updates Medical Home Standards Amidst Criticism for Lack of Focus on Outcomes

The National Committee for Quality Assurance (NCQA) is updating its standards for Patient-Centered Medical Home Recognition, as concern grows that the standards focus too heavily on structural elements of medical homes and not enough on outcomes.

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