SCI Solutions is expanding from its referral management and patient scheduling base by acquiring Clarity Health, which offers prior authorization and referral management services.
A survey from the American College of Emergency Physicians claims that more patients are using the ER due to narrow networks and high deductibles. This is a blatantly flawed survey (just read the question composition) designed solely for the purpose of pressuring health plans to pay ER doctors more. It is simply disgraceful for a profession like medicine to corrupt science in this way and it ignores the fact that larger networks and richer benefits raise premiums, which also hurts patients.
In a somewhat complex transaction, MedAssets, the GPO and health system consulting firm, which had run into trouble by overpaying in acquisitions, is being bought by a PE firm, with its supply chain and data analytics business largely resold and combined with those of Novation, and the PE firm retaining its revenue cycle management services and combining them with Precyse.
In a somewhat alarming report, research in the journal Anesthesiology finds a high rate of medication problems in connection with surgeries. In 277 operations there were 3671 medication administrations and 193 medication errors or adverse drug events, of which 70 were judged to have the potential for harm. 153 were preventable and 99 were considered serious.
According to an Advisory Board survey, providers are requiring more upfront payment of cost-sharing amounts by patients, largely as a result of the growth of high-deductible plans.
CMS released findings for the latest year of hospital value-based purchasing, indicating that based on 2014 performance, for 2016 payments 1800 hospitals will get some "bonus" reimbursement. Note, however, that the bonus is after everyone had their payment docked 1.75% to fund the program. Only a few hospitals will see an actual increase in payment from what the baseline would otherwise be. For the vast majority of hospitals, the net effect is very minor.
In a report indicating just how pathetic the controls in the reform law are for protecting Medicaid and the subsidy program from fraud, ten of ten fictitious people created by the Government Accounting Office were able to incorrectly obtain either Medicaid coverage or a public exchange subsidy. Your tax dollars at work.
http://www.gao.gov/products/GAO-16-159T
Oct282015
Walgreens is proposing to buy Rite-Aid for $9.4 billion, in another major consolidation of the US health care system which needs very careful regulatory scrutiny.
Research in Health Affairs finds that prescription copays under the typical exchange silver plan are twice as high as in average employer plans. More good news for health care reform.
You may have noticed that there soon will be none of the health insurance cooperatives established (and taxpayer-funded) under the reform law, as every week brings news of closures of more of them. Strangely, no boasting from the Administration about this latest indication of the great success of their health reform.
Population health management (whatever that means) vendor Welltok has acquired Zamzee to add to its offerings to encourage children to participate in health improvement activities.
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at khroche@healthy-skeptic.com.
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at khroche@healthy-skeptic.com.