MGMA e-News ScanMGMA e-News Scan

MGMA will phase out the e-News Scan on Aug. 1, 2014. In its place, we encourage you to visit our new article archive that highlights industry coverage through blogs, email newsletters, magazines and web content. We will redirect readers to this new page Aug. 1 and encourage you to subscribe to the MGMA In Practice Blog and Washington Connection to ensure that you do not miss out on late-breaking news and industry coverage through these publications.  

Hospitals To Pay Big Fines For Infections, Avoidable Injuries
By: - Tue, 24 Jun 2014 11:03:38 -0400
Medicare is preparing to penalize about 750 hospitals that have the highest rates of infections and patient injuries. The sanctions, estimated to total $330 million over a year, will kick in at a time when most infections and accidents in hospitals are on the decline, but still too common.

Shape-Up And Checkup: LA Barbers To Start Testing Blood Pressure
By: Shereen Marisol Meraji - Tue, 24 Jun 2014 11:03:04 -0400
Barbershops are a traditional gathering place for African-American men — a place to talk politics, sports and gossip. Now, some doctors in Los Angeles are hoping to make the barbershop a place for combating high blood pressure among black men.

Drug Discount Program Has Drugmakers Crying Foul
By: Kristian Foden-Vencil, Oregon Public Broadcasting - Tue, 24 Jun 2014 10:58:47 -0400
As the feds have been drawing up new rules for the drug discount program, a pitched battle has broken out between hospitals and drug manufacturers who say the program, known as 340B, is now bloated and badly regulated.

How the U.S. Health Care System Compares Internationally
By: The Commonwealth Fund - Tue, 24 Jun 2014 10:57:56 -0400
The United States health care system is the most expensive in the world, but this report and prior editions consistently show the U.S. underperforms relative to other countries on most dimensions of performance.

Differentiating Physicians for Competitive Advantage
By: Hospitals & Health Networks - Tue, 24 Jun 2014 10:57:20 -0400
The five A's — availability, affability, ability, affordability and accountability — can determine the success of your organization.

Slideshow: The Clinical Strategy for Financial Health—Care Redesign and Standardization
By: HCPro, Inc. - Fri, 13 Jun 2014 07:14:00 -0400
While there are many barriers to attaining sustainable cost reductions, hospitals and health systems are looking for ways to continue serving their communities while cutting costs.

AP report finds VA falling short on another commitment: female medical issues
By: Washington Post - Sun, 22 Jun 2014 17:38:37 -0400
The beleaguered department is not meeting its commitment to attend to the needs of the rising ranks of female veterans.

Private ACOs look promising
By: Healthcare Finance News - Wed, 11 Jun 2014 09:12:09 -0400
While Medicare's ACOs have had mixed early outcomes, some young commercial accountable care ventures, including PPO plans, are showing promise.

An up-and-coming executive role: chief population health officer
By: Healthcare Finance News - Wed, 11 Jun 2014 09:10:24 -0400
With population health management becoming a central focus for more healthcare providers, a growing number are considering adding a chief population health officer to the executive ranks.

Massachusetts Inches Toward Health Insurance For All
By: - Wed, 11 Jun 2014 09:09:36 -0400
When Massachusetts passed its landmark health insurance law under Gov. Mitt Romney in 2006, no one claimed the state would get to zero — as in 0 percent of residents who are uninsured. But numbers out this week suggest Massachusetts is very close.

School Nurses' Role Expands With Access To Students' Online Health Records
By: Michelle Andrews - Wed, 11 Jun 2014 09:06:30 -0400
As both schools and healthcare systems seek to ensure that children coping with chronic conditions such as diabetes and asthma get the comprehensive, coordinated care the students need, the schools and health systems are forming partnerships to better integrate their services. 

Presidents, CEOs, and the New Healthcare Leadership Model
By: HCPro, Inc. - Tue, 10 Jun 2014 07:48:00 -0400
Some hospital CEOs, used to captaining their own ship, are finding that healthcare reform means there are fewer opportunities to run things as they see fit. Maybe that's a good thing.

Parents Of Mentally Ill Adult Children Frustrated By Privacy Law
By: Jenny Gold - Mon, 09 Jun 2014 11:18:21 -0400
Some parents of adult children with mental illnesses fear that their child will go untreated, suffer, or, at worst, become violent. And often, as the people who care the most about them, many parents want the doctors, social workers and other providers to share protected patient information. 

Can Employers Dump Workers To Health Exchanges? Yes, For A Price
By: Capsules - Mon, 09 Jun 2014 11:17:27 -0400
Nothing stops employers from canceling company plans and leaving workers to buy individual policies sold through the exchanges — as long as they pay the relevant taxes and penalties, said Christopher Condeluci, a Venable lawyer specializing in benefits and taxes. Those will vary according to a company’s size and circumstances.

Hospitals Push Bundled Care as the Billing Plan of the Future
By: Melinda Beck - Mon, 09 Jun 2014 11:16:57 -0400
Traditionally, hospitals have charged patients separately for every service and supply they use—as anybody who has waded through pages of charges knows. Fees for surgeons, anesthesiologists and other providers come in complex bills of their own. Now, more hospitals see so-called bundled payments as the wave of the future.

Pre-Existing Condition Bans – Are They Really Gone?
By: Capsules - Mon, 09 Jun 2014 11:15:47 -0400
Under the law, the only plans that may continue to exclude coverage for pre-existing conditions after that date are individual plans that are “grandfathered,” or haven’t changed substantially since the law was passed in 2010.

Medicare Could Save Billions By Scrapping Random Drug Plan Assignment
By: Capsules - Mon, 09 Jun 2014 11:16:30 -0400
A new study finds that Medicare is spending billions of dollars more than it needs to on prescription drugs for low-income seniors and disabled beneficiaries.

For Some Doctors, Almost All Medicare Patients Are Above Average
By: - Thu, 15 May 2014 12:15:30 -0400
Recently released Medicare data show that 1,800 doctors and other health providers nearly always charge Medicare the highest rate for patient care. Experts challenge the legitimacy of the charges.

Mental Health Integration in Primary Care
By: HCPro, Inc. - Thu, 29 May 2014 08:01:00 -0400
Intermountain leaders have developed a team-based approach to effectively address patients' mental health issues.

What the VA Scandal and Medicare Cost Issues Have in Common
By: Chris Jacobs - Fri, 30 May 2014 16:29:19 -0400
Chris Jacobs: Health-care systems respond to incentives set by the federal government. But the VA scandal and Medicare physician reimbursements show that Washington has not proved nimble enough to avert unintended consequences of those responses.

Leverage post-acute care data to improve your value proposition
By: Healthcare IT News - Mon, 02 Jun 2014 12:03:01 -0400
Many health systems and collaborative care organizations have already begun to tackle the interoperability challenges of connecting physician practices, laboratories, clinics and hospitals to produce a seamless flow of information among primary and acute care providers, but a critical interoperability component may be absent.

Patients' Preferences Explain A Small But Significant Share Of Regional Variation In Medicare Spending
By: Baker, L. C., Bundorf, M. K., Kessler, D. P. - Sun, 01 Jun 2014 01:00:00 -0400
This study assessed the extent to which differences in patients’ preferences across geographic areas explained differences in traditional fee-for-service Medicare spending across Dartmouth Atlas of Health Care Hospital Referral Regions (HRRs). Preference measures were based on results of a survey that asked patients questions about their physicians, their own health status, and the care they would want in their last six months of life.

First National Survey of ACOs Finds That Physicians Are Playing Strong Leadership and Ownership Roles
By: The Commonwealth Fund - Tue, 03 Jun 2014 11:08:00 -0400
This Commonwealth Fund–supported article reports on findings from a new national survey of ACOs that examined the extent to which physicians are engaged in the leadership of ACOs, have boards that are run by physicians, and are physician-owned.

Prescription for Narrow Networks: Add Transparency
By: HCPro, Inc. - Wed, 04 Jun 2014 07:57:00 -0400
Removing the consumer pinch from narrow provider networks in individual insurance exchanges is a matter of striking a "delicate balance" between payers and the insured, suggests a Robert Wood Johnson Foundation report.

Growth and Variability in Health Plan Premiums in the Individual Insurance Market Before the Affordable Care Act
By: The Commonwealth Fund - Wed, 04 Jun 2014 23:00:48 -0400
Before we can evaluate the impact of the Affordable Care Act on health insurance premiums in the individual market, it is critical to understand the pricing trends of these premiums before the implementation of the law.

The Employer Mandate: Essential or Dispensable?
By: The Commonwealth Fund - Wed, 04 Jun 2014 12:17:00 -0400
Some may therefore be surprised by the growing talk of repealing the ACA's requirement that employers cover their employees. To unpack this issue, The Commonwealth Fund's David Blumenthal, M.D., and David Squires take a look at the ACA provision itself, why it was enacted, and the potential upside and downside of repeal.

Restoring Trust in VA Health Care
By: Kenneth W. Kizer et al - Wed, 04 Jun 2014 17:00:05 -0400
To some observers, the VA's problems confirm that government cannot manage health care. To others, they tell a simple story of insufficient funding: the VA needs more money to care for the large number of veterans returning from the wars in Iraq and Afghanistan and for aging Vietnam veterans. Unfortunately, neither narrative adequately captures the challenges facing this organization or provides guidance on how we might address them.

3 ways to help avoid a coding audit
By: - Tue, 13 May 2014 09:22:36 -0400
There is a way to effectively monitor provider documentation to prevent any future audits and to ensure that any office visit that is coded with a higher severity is justified, she says. Consider the following tips to reduce the risk of a coding audit.

Rural Hospitals Weigh Independence Against Need For Computer Help
By: - Thu, 24 Apr 2014 17:36:57 -0400
Hospitals in out-of-the-way places are making trade-offs as they adopt electronic medical records. Some are joining larger health systems, while others are searching for ways to go it alone.

ACOs get down to brass tacks
By: Healthcare Finance News - Tue, 13 May 2014 09:15:31 -0400
Although accountable care organizations are still in nascent stages in many areas of the country, a few large provider groups are ahead of the curve, getting into the nuts and bolts of how these alliances should exist, operate and perform.

Harvard: Overused Medical Services Cost Medicare Billions
By: Capsules - Tue, 13 May 2014 09:13:09 -0400
Medical overtreatment is the inverse of former Supreme Court Justice Potter Stewart’s definition of pornography: while easy to define in concept, it can be hard to know it when you see it.

The doctor will see you now via webcam, smartphone
By: Associated Press - Tue, 13 May 2014 09:11:32 -0400
The virtual house call, the latest twist on telemedicine, is increasingly getting attention as a way to conveniently diagnose simple maladies, such as whether that runny nose and cough is a cold or the flu. One company even offers a smartphone app that lets tech-savvy consumers connect to a doctor for $49 a visit.

What Surge? Nation's Primary Care System Holding Up Well So Far Under Obamacare
By: Phil Galewitz - Tue, 13 May 2014 09:10:32 -0400
Despite dire predictions, the nation’s primary care system is handling the increased number of insured patients without major problems so far, according to interviews with community health centers, large physician practices and insurers nationwide.

Defining What 'Defined Contributions' Mean For Work-Based Health Insurance
By: Michelle Andrews - Tue, 13 May 2014 09:09:04 -0400
The idea that employers might decide to drop their health plans and replace them with a “defined contribution” for employees has been around for years. Now that the health law has created new online marketplaces where people can shop for coverage and made the individual market more accessible and affordable, the idea is gaining traction.

New Report: $3 Billion in Total Consumer Benefits from Affordable Care Act's Medical Loss Ratio Provision
By: The Commonwealth Fund - Tue, 13 May 2014 06:16:04 -0400
The Affordable Care Act's medical loss ratio (MLR) provision has benefited consumers to the tune of $3 billion in 2011 and 2012, either through the rebates that insurance companies have paid to them or through reduced health plan spending on overhead, according to a new Commonwealth Fund report.

Can Google Glass Get Any HIPAA?
By: HCPro, Inc. - Wed, 30 Apr 2014 07:44:00 -0400
Google Glass is a hip new accessory gaining acceptance in clinical settings, but before widespread adoption can take place, organizations must ensure that the wearable device is HIPAA-compliant.

Opinion: A doctor's declaration of independence
By: Business News & Financial News - Wed, 30 Apr 2014 09:09:24 -0400
How we interact and treat our patients is the practice of medicine. I acknowledge that there is a problem with the rising cost of health care, but there is also a problem when the individual physician in the trenches does not have a voice in the debate and is being told what to do and how to do it.

Deadlines, stress cause leaders to make poor choices
By: Katie Sullivan - Tue, 29 Apr 2014 11:17:56 -0400
Neuroimaging can show how leaders and executives make decisions and react to situations, leading to a clearer picture of the processes and thoughts behind tough decision-making, the Wall Street Journal reported.

Technology Insights to Help Hospitals Navigate the 'Perfect Storm'
By: Robert J. Szczerba - Wed, 30 Apr 2014 01:00:00 -0400
In the rapidly changing healthcare industry, keeping up with new technologies and innovations has become less of a desire and more of a requirement. To better understand the potential impact of these new changes, we reached out to executives at several organizations in the healthcare sector. 

Telemedicine's Expanding Options
By: HCPro, Inc. - Tue, 29 Apr 2014 07:44:00 -0400
Spurred by new laws and policies that permit online teleconsultations, both payers and providers are exploring ways to enable patients' access to care in ways that also meet growing industry demands.



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