By Deanne Kasim – With the increase in specialty drugs, innovative diagnostic testing, and precision medicine, it is expected that the use of the Prior Authorization will only increase with health insurance companies. Of course I have heard from many re: the (theoretical) fact that as the use of value-based provider reimbursement matures, there will be less and less need for a PA process.
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By Roger Davis – “We are deadly serious about interoperability.” – Andy Slavitt, Acting Administrator of the CMS at the J. P. Morgan Healthcare Conference in San Francisco in January 2016. For those of us in the healthcare vendor community, that defining statement sets the tone for the future interaction between organizations.
By Patrick Conway MD – Last year, a bipartisan Congressional majority passed the Medicare Access and CHIP Reauthorization Act of 2015, or MACRA. We have worked in the same spirit as the law’s model of partnership and progress as we implement policies to improve the health and well-being of Americans.
By Susan Jaffe – Despite interventions by Medicare officials, the number of appeals from health care providers and patients challenging denied claims continues to spiral, increasing the backlog of cases and delaying many decisions well beyond the timeframes set by law, according to a government study released on June 9th.
By Matt Patterson MD – In May, The Joint Commission announced that it was changing its five-year-old ban on texting, stating that effective immediately health care organizations may now allow orders to be transmitted via text message. The topic of ‘secure messaging’ has long been a polarizing topic within the health care industry.
By Ashish Jha – Get a group of health policy experts together and you’ll find one area of near universal agreement: we need more transparency in healthcare. The notion behind transparency is straightforward; greater availability of data on provider performance helps consumers make better choices and motivates providers to improve.
By Mary Hatcher – Last year I heard former president George W. Bush speak about his 2004 vision for healthcare, which included electronic health records centered around a single patient identifier. He provided a clear example for this vision that resonated with me. He asked us to imagine someone had been in a terrible accident.
Fewer than a quarter of U.S. hospitals are on track to hit the Obama Administration’s 2018 goal of providing at least half their patient care through so-called “value-based” arrangements – structures that tie reimbursement from Medicare to the quality of care patients receive.
By Hitender Soni – Chronic diseases and conditions—such as heart disease, stroke, cancer, diabetes, obesity, arthritis—are among the most common, costly, and preventable of all health problems. In the past, Medicare has only approved incentive payment for non-face-to-face chronic care management.