Court decision means cost sharing could be reinstated for some preventive healthcare services
Comprehensive coverage of some preventive care services could be jeopardized by a recent court ruling. Since its passage, the Affordable Care Act (ACA) had required health plans to cover the full cost of services that received an “A” or “B” rating from the U.S. Preventive Services Task Force (USPSTF). A federal judge in Texas ended…
Maryland’s all-inclusive population health payment model continues to show promise, but nonhospital spending poses a concern
An innovative payment model for Maryland healthcare providers has improved utilization, cost and quality thus far, but an increase in nonhospital spending requires further study. The Center for Medicare & Medicaid Innovation (CMMI) released an analysis of the first three years of Maryland’s Total Cost of Care Model, an effort to improve population health management.…
In federal ACO programs, advocates see signs of slow but steady progress
Growth in accountable care organization (ACO) programs has been inconsistent since the Affordable Care Act made accountable care part of the healthcare lexicon in 2010. Nonetheless, proponents are optimistic about the state of ACOs and their potential in upcoming years, even if there’s uncertainty about CMS’s ability to achieve its stated goal of ensuring every…
Healthcare News of Note: Most healthcare CEOs are optimistic about the future of their business despite a potential recession
Most of the CEOs in the Healthcare, Media & Entertainment, Telecom & Cable, and Aerospace & Defense sectors indicated being somewhat or extremely optimistic about the future of their business even in the face of a potential recession. While roughly one-third of 2021 hip and knee replacement episodes were performed by providers with 100 or…
Healthcare News of Note: How to prevent pediatric mental health revisits
A new study provides a better understanding of the trends and factors associated with an increase in pediatric mental health ED revisits. Black and brown skin tones are underrepresented in medical training and textbooks, which can lead to missed diagnoses and inequities in care. Dermatologists are doing what they can to address the issue. A…
Healthcare News of Note: More than 3,500 deaths in the US attributed to long COVID during a 30-month period
For a 30-month period beginning in January 2020, long COVID played a part in the deaths of 3,544 people, according to a report by the CDC’s National Center for Health Statistics. The Department of Justice has support from hospital advocates as it looks to appeal a court ruling that allowed UnitedHealth Group to acquire Change…
How health systems can support underserved patients through in-home care
Finding a way to deliver high-touch care to vulnerable and underserved patients using the patient’s home as the primary point of care has become a strategic priority for providers. The strategic shift to a focus on in-home care for these populations stems from increasing pressure on health systems to lower the cost of care for populations they serve while solving for the challenges presented by social determinants of health.
Telehealth is primed for growth despite post-lockdown fade
If our nation is to achieve true cost effectiveness of health, virtual healthcare must play a pivotal role. Here, two health system leaders share lessons learned from their efforts to develop effective telehealth programs as a key component in their long-term value-focused care strategies, and two thought leaders weigh in on keys to telehealth success.
Healthcare News of Note: Even many people with ‘good’ health insurance incur medical debt
Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: 20% of U.S. households have medical debt, regulatory issues are delaying completion of a proposed not-for-profit health system mega-merger, and racial and ethnic disparities are seen in drug overdose deaths.
Gail Wilensky: Achieving health equity in the U.S. requires a preventive approach
Social determinants of health (SDoH) present a severe challenge for our nation by perpetuating inequities both in access to care and in the quality-of-the outcomes of care. Although interventions that address the challenges posed by SDoH are helpful throughout a person’s life, they can be most helpful if they occur early on, with a focus on enhancing early childhood education and food security.