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Care Delivery

 

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.

The transition to value-based care has led to consolidation and increased physician employment, but smaller practices may find a different option in pursuing alignments with other organizations which don’t involve giving up their independent status.

Nurses at Tufts Medical Center in Boston are planning to go on a one-day strike on July 12, while the hospital has hired enough replacement nurses for a five-day lockout.

 

Recent Headlines

New ACO model for dual-eligible beneficiaries announced by CMS

CMS has announced the creation of the Medicare-Medicaid Accountable Care Organization (ACO) model, aiming to improve care coordination for beneficiaries who are enrolled in both programs.

Mississippi ranked last in annual state health report

High levels of smoking and poverty contributed to Mississippi being ranked 50th in the 2016 edition of America’s Health Rankings from the United Health Foundation, which also identified some national trends which could reverse recent gains made in other categories of health.

ACA exchange sign-ups outpacing last year

The number of enrollees in plans offered on health insurance exchanges has increased slightly compared to the last open enrollment period, with sign-ups accelerating before the deadline to get coverage starting Jan. 1, 2017.

Flu vaccine coverage well below CDC targets

The Centers for Disease Control and Prevention (CDC) reported only 40 percent of Americans have received this season’s flu vaccine. It’s about the same coverage as the prior season—but well behind the agency’s target of 70 percent.

Retail clinics aren’t reducing unnecessary ED visits

Having a retail health clinic nearby isn’t steering patients away from going to the emergency department (ED) for common low-acuity conditions.

Anthem allowed to move forward with PPO to EPO switch in California

A California judge denied a request for a restraining order which would have stopped Anthem from moving 500,000 customers to plans that only cover out-of-network charges in an emergency.

Med school blues: 45% of students feel burned out

Feeling overworked is common among physicians, but even those still pursuing their medical degrees are more likely to suffer from burnout.

CMS approves Massachusetts’ transition to ACO model for Medicaid

A five-year, $52.5 billion Medicaid waiver for Massachusetts has been approved by CMS, allowing the state to reorganize its MassHealth program and transition to an accountable care organization (ACO) model.

CMS's Slavitt: Healthcare can’t rely on old ways in ‘new normal’

CMS Acting Administrator Andy Slavitt said the healthcare industry’s move away from volume and towards value-based care will be worth the short-term disruption in remarks to the American Academy of Actuaries.

Mom who gave birth in hospital parking lot surprised at full delivery charge

Paula D’Amore expected to pay a little less for giving birth to her daughter in April, because she never actually made it inside Boca Raton Regional Hospital.

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