Medicare Testing Payment Options That Could End Observation Care Penalties
The pilot projects underway at hospitals eliminate the requirement that seniors must be admitted for three days before they qualify for nursing home coverage.
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Feds Urge State Medicaid Programs To Encourage Long-Acting Contraceptives
Medicaid spends billions on unintended pregnancies, and federal officials say better use of long-acting contraceptives, such as IUDs, offer advantages for women and are cost-effective.
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Methodology: How Hospital-Acquired Conditions Are Calculated
Before assessing penalties, Medicare assesses rates of infection among patients with catheters in major veins and in the bladder and eight other patient injuries, such as blood clots, bed sores and accidental falls.
By Jordan Rau -
Obama Administration Retreats On Private Medicare Rate Cuts
But insurers still contest the claim that rates will rise slightly after arriving at their own calculations of the originally proposed cuts.
By Jay Hancock -
For Hospitals, Prestige Leads To Profits
A new study explores why the most profitable U.S. hospitals are who they are.
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Q&A: Can Claims Data Crack the Health Care Cost Riddle?
More states are creating all-payer claims databases. Find out how they work.
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Lawmakers Weigh Changes To Medicare
The House this week held a hearing on payment shifts in Medicare Advantage plans and has scheduled a vote Friday on a proposal to revamp the system for paying doctors. KHN's Mary Agnes Carey and Politico Pro's Jennifer Haberkorn discuss the issues.
By alley -
How Medicare Drug Plans Hope To Follow Private Sector Lead
The proposal that Medicare made this month to better control prescription drug costs involves testing strategies used with some success in the private sector.
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Some Dialysis Patients Give Medicare Failing Grade On Ambulance Trial
A Medicare trial aimed at averting billing fraud and waste in nonemergency ambulance service in eight states is drawing complaints from patients’ families and ambulance companies.
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Co-op Health Insurance Plans See Early Success
Montana's health insurance co-op is encouraged by its strong enrollment and plans to expand into Idaho next year. But some caution that it will be difficult for co-ops to grow beyond a niche player.
By Eric Whitney -
Medicare Records Provide Tantalizing New Details Of Payments To Doctors
But physicians and database experts caution that the information can be easily misconstrued or misunderstood.
By Jordan Rau -
Hospital Closures Rattle Small Towns
More than 50 shuttered rural hospitals mean a loss of jobs and other commerce for municipalities and uncertain care for residents.
By Sarah Varney -
New Kaiser Permanente Med School Part Of A Growing Trend
Twenty new schools opened in the past decade; but some doubt whether so many new doctors are needed.
By Julie Rovner -
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Medicaid To Fund More Addiction Treatment
Some Medicaid plans will now get federal funding for 15 days of inpatient treatment. But Pennsylvania fears the new rule will close a loophole the state has been using to pay for longer stints.
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Report: Home Care Workers Need Better Job Protections
Stricter oversight is required to ensure employers comply with labor standards, says worker advocacy group.
By Anna Gorman -
In Miami, Medicare Comes With White-Glove Treatment
More than half of all eligible seniors in Miami-Dade and Broward counties enroll in private managed care, rather than traditional Medicare, in a highly-lucrative and super-competitive marketplace for Medicare Advantage plans.
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California To Revamp Addiction Treatment For Medicaid Recipients
Through what’s known as a drug waiver, state officials will have new spending flexibility as they try to improve outcomes and reduce social and financial costs of people with substance abuse disorders.
By Anna Gorman