You are here

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

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.

CMS: 45% of provider locations in Medicare Advantage directories are inaccurate

A CMS review of provider directories set up by Medicare Advantage plans found many listed the wrong phone numbers or locations for physicians or incorrectly labeled physicians as accepting new patients.

Long-term uninsured made up most of ACA’s initial coverage gains

People who had gone three years or more without having health insurance made up more than half of the gains in coverage in 2014, the first year of the Affordable Care Act (ACA)’s insurance marketplace and Medicaid expansion. 

Half of ICU patients didn’t need intensive care in single-center study

More than half of intensive-care unit (ICU) patients (53 percent) at one large teaching hospital would have received more appropriate care in a different, less intensive setting. 

WellCare acquires Arizona health plans, names new leadership

Medical insurance company WellCare Health Plans has acquired two Arizona health plans and named a new executive to oversee the transition.

Pages