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Care Delivery

 

The second year of the Merit-based Incentive Payment System (MIPS) has proposed new option for participation, with clinicians able to join together in “virtual groups” to report on MIPS performance measures.

The average millennial—someone born between 1982 and 2000—is nearly twice as likely to become a registered nurse (RN) than a baby boomer, a “surprising surge of interest” potentially averting a large national shortage of nurses.

In 2016, there were more than 200 freestanding emergency departments (EDs) in Texas, the center of a boom in these sites of care. With far fewer restrictions on where they can be built compared to hospital-based EDs, most of these facilities have been built in areas where residents have higher household incomes.

The 626 health systems in the U.S. accounted for the majority of hospitals, beds and discharges in 2016, according to data released by the Agency for Healthcare Research and Quality (AHRQ).

Group market insurance plans had premiums increase by an average of 3 percent this year, the sixth consecutive year of a single-digit hike and well below the 20 percent jump in non-group market premiums, while employers continue to search for ways to cut costs through different sites of care and wellness programs.

 

Recent Headlines

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.

Reducing Unnecessary Readmissions Requires Carrots, Not Just Sticks

Lowering unnecessary hospital readmission rates is an often cited solution to the problem of high U.S. health care costs. However, to effectively do so, the health care system needs to reward all stakeholders for collaborating, not just punish hospitals for unnecessary readmissions, a new report finds.

Wisconsin Hospitals Raise the Quality Bar—Across the Board

Reducing readmissions remains one of the most difficult challenges for hospitals everywhere. Members of the Wisconsin Hospital Association (WHA), however, have been working together to reduce the incidence of hospital readmissions within 30 days of discharge—and their performance runs far ahead of the national average.

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