Quality

The focus of quality improvement in healthcare is to bolster performance and processes related to diagnostic and therapeutic procedures. Leaders in this space also ensure the proper selection of imaging exams and procedures, and monitor the safety of services, among other duties. Reimbursement programs such as the Merit-based Incentive Payment System (MIPS) utilize financial incentives to improve quality. This also includes setting and maintaining care quality initiatives, such as the requirements set by the Joint Commission.

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Class action lawsuit filed against Anthem for deceptive marketing

Anthem, the second largest health insurer in the nation, is facing a class action lawsuit for allegedly misleading thousands of Georgia consumers during the 2018 open enrollment period.

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Fake pharmacist handled 700,000 prescriptions at Walgreens

An individual who signed off on or dispensed more than 745,000 prescriptions over roughly a decade at three Walgreens stores in the Bay Area was not a licensed pharmacist, The LA Times reported.

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Johns Hopkins All Children’s on brink of losing Medicare funding

Johns Hopkins All Children’s Hospital in St. Petersburg, Florida, could lose its Medicare funding if it doesn’t shape up after a recent inspection found serious problems at the institution, The Tampa Bay Times reported.

VA proposes changes to standards of care

The Department of Veterans Affairs (VA) announced a proposal to change access standards for community care and urgent care by allowing veterans to seek care with the VA or other community providers.

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Drop in hospital-acquired conditions saved $7.7B

Hospitals are becoming safer places for patients, after a decline in hospital-acquired conditions saved approximately 20,000 lives and $7.7 billion in costs, according to data from the Agency for Healthcare Research and Quality (AHRQ).

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Study finds e-cigarettes can help smokers quit

E-cigarettes may actually help smokers quit, according to a recent study in the New England Journal of Medicine.

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UnitedHealthcare to pay $91M after denying coverage to some patients

UnitedHealthcare, the nation’s largest health insurer, will have to shell out $91 million to patients who were wrongfully denied coverage for some healthcare services.

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Hip and knee replacements, costs on the rise in the US

Planned hip and knee replacements are on the rise in the U.S., including among younger Americans, according to an analysis from the Blue Cross Blue Shield Association (BCBSA).

Around the web

Compensation for heart specialists continues to climb. What does this say about cardiology as a whole? Could private equity's rising influence bring about change? We spoke to MedAxiom CEO Jerry Blackwell, MD, MBA, a veteran cardiologist himself, to learn more.

The American College of Cardiology has shared its perspective on new CMS payment policies, highlighting revenue concerns while providing key details for cardiologists and other cardiology professionals. 

As debate simmers over how best to regulate AI, experts continue to offer guidance on where to start, how to proceed and what to emphasize. A new resource models its recommendations on what its authors call the “SETO Loop.”