House passes American Health Care Act
Editor's Note The US House of Representatives on May 4 passed the American Health Care Act with 217 yes votes; 216 was the number needed. The bill now moves to the Senate. The House Republicans passed the American Health Care Act with a slim majority on Thursday. The bill gives…
Bill to repeal, replace Affordable Care Act released
Editor's Note The 123-page bill, called the “American Health Care Act,” was released March 6, Modern Healthcare reports. The bill replaces the Affordable Care Act’s (ACA’s) income-based premium tax credits with age-based tax credits. It also enhances federal funding for states to expand Medicaid to low-income adults, and it converts…
Use of high-, low-quality hospitals by uninsured
Editor's Note Despite the Affordable Care Act, which was designed to improve access to care for patients without insurance, patients without insurance have lower use of high-quality hospitals, this study finds. The probability of admission to high-quality hospitals was similar for patients with Medicaid (23.3%) and private insurance (23.0%), but…
Editorial
Healthcare consumers and providers alike are watching to see what changes will occur under the administration of President-elect Donald Trump. Thus far, at least a partial repeal of the Affordable Care Act (ACA) seems likely. That’s in part because US Rep Tom Price (R-GA) is Trump’s pick for Health and…
Medicare Advantage pays hospitals 8% less than traditional Medicare
Editor's Note Medicare Advantage plans paid hospitals 8% less for hospital services than fee-for-service Medicare in 2009 and 2012, finds this study. Researchers also found that commercial insurers paid hospitals much higher than Medicare Advantage or fee-for-service Medicare. Some of this difference is because of higher prices commercial plans pay…
Help decode ICD-10 for prompt reimbursement
Despite warnings of calamities, implementation of the International Classification of Diseases (ICD)-10 on October 1, 2015, proceeded smoothly, with minimal impact on denied claims. In the fourth quarter of 2015, the percentage of Medicare claims denied was 10%, comparable to the preimplementation figure of 9.9%. But that doesn’t mean OR…
CMS, FDA advocate for UDI use in insurance billing
Editor's Note The Centers for Medicare & Medicaid Services (CMS) and Food and Drug Administration (FDA) are recommending using unique device identifiers (UDIs) in universal health insurance claims forms to improve value-based reimbursement for medical devices and postmarket surveillance, the July 14 Modern Healthcare reports. Proponents say UDIs could help…
June healthcare security breaches affect 11 million patient records
Editor's Note June was the worst month of 2016 for healthcare information security, with 29 breaches that affected more than 11 million patient records, the July 7 Healthcare IT News reports. A total of 24 healthcare providers accounted for 86% of the breaches, with three occurring at health plans and…
Hospital readmission app could save billions
Editor's Note Hospital readmission app could save billions An award-winning app developed by graduate students at Binghamton University, State University of New York, could help reduce readmission rates and save the healthcare industry billions. The Android-based mobile app called “Post Discharge Treatment and Readmission Predictor,” creates a special messaging service…
Healthcare providers struggling to transition to VBP
Editor's Note Moving to information systems and data requirements of the new value-based payment (VBP) reimbursement system is proving to be a daunting challenge for healthcare providers, the June 13 Health Data Management reports. A survey of healthcare executives from 190 hospitals shows that only 3% of respondents provide more…
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