Efforts to repeal and replace the Affordable Care Act (ACA) are ongoing, with continued uncertainty about what may happen and when. To keep things in perspective, here’s a snapshot of recent developments. On May 4, the US House of Representatives approved the American Health Care Act (AHCA) by a vote…

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Editor's Note According to statistics from the Agency for Healthcare Research and Quality (AHRQ), in 2014, 17.2 million hospital visits (inpatient and outpatient) included surgical procedures. More than half (57.8%) occurred in a hospital-owned outpatient surgery setting, and the remaining (42.2%) were inpatient. Private insurance was the primary payer for…

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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…

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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…

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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…

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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…

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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…

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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…

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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…

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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…

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