One of the dilemmas Medicaid managed care plans find themselves in when they are trying to integrate physical and behavioral health care, is that due to confidentiality and consent laws, a physician can't disclose that a patient is on an anti-psychotic without getting all the required permissions, speakers said at a meeting on Medicare, Medicaid, and Dual Eligibles sponsored by America's Health Insurance Plans. Getting primary care physicians comfortable with mental health diagnoses is another barrier to integra
As ACOs continue to progress, they are seeking to expand population health management capabilities, including their relationships with community organizations and patients, according to research from Premier. The report, with support from the Robert Wood Johnson Foundation, found
David Chou, VP and chief information and digital officer at Children's Mercy Kansas City, believes health care CIOs can help their organizations remain competitive following the implementation of MACRA's Merit-Based Incentive Payment System (MIPS). Chou says CIOs should also coordinate with physician leaders in sponsoring trainings on the EHR workflow process. He outlines three strategies to remain competitive under MACRA:
The University of New Mexico Health System is partnering with Genesis HealthCare to create clinical programs to improve care access and reduce hospital readmissions among nursing facility residents. The clinical programs will take place in the Albuquerque area, where Genesis operates 10 facilities, and other parts of the state to address issues that arise during transitions of care between hospitals and long-term care facilities.
A report in JAMA Pediatrics found children's hospitals lose more money than other facilities treating children covered by Medicaid. It also found they may be under pressure in 2018 when federal payments compensating for this loss are lowered. According to the study, Medicaid often pays less than actual hospital costs for services, adding hospitals lost $14.4 billion in 2014 from Medicaid underpayment.
The task force Gov. Charlie Baker formed to tackle the state's opioid problem is reassembling for the first time in 15 months to confront hepatitis C. The meeting of Baker's opioid working group is intended to address "new areas of focus," including the rise in hepatitis C cases, which went unaddressed in the group's initial report but experts say is largely tied to the heroin scourge, according to Marylou Sudders, the state's HHS secretary.
Changing Medicaid into a program with per-capita spending caps would require consideration of what benefits would be covered, how the money would be allocated and how states would be held accountable for spending the funds, according to a GAO report, which identified four areas of key policy considerations:
The Greater Buffalo United Accountable Care Organization is the first ACO in New York State to serve Medicaid and commercial insurance patients. The roughly 320 primary care physicians and specialists in the organization handle about 65,000 patients. The first commercial insurer to join the local organization is YourCare Health Plan, the regional, not-for-profit health plan that serves Western New Yorkers who are eligible for government-sponsored coverage.
CMS finalized a rule to bolster emergency preparedness of certain providers participating in Medicare and Medicaid. The emergency preparedness requirements aim to increase patient safety during emergencies and establish a more coordinated response to natural and man-made disasters. Some providers and suppliers will be required to plan for disasters and coordinate with federal, state tribal, regional, and local emergency preparedness systems by meeting four best practice standards:
Two UMass Amherst researchers received a three-year, $425,000 grant from the National Science Foundation to study cancer that has metastasized into bones from other organs in the body. The research team from the department of mechanical and industrial engineering will focus on breast cancer since approximately three in four patients with advanced breast cancer develop incurable bone metastases. Their goal is to define the functional relationship between mechanical signals and bone metastatic cell function.
Inmates in Delaware who leave prison in poor health can have trouble getting immediate access to health care when released, but Christiana Care Health System has an idea for how to solve that problem. Following the model of six states, Christiana Care is looking at establishing a transitions care clinic - a clinic that would provide primary care to patients who were previously in jail. Christiana Care is seeking ways to make sure those leaving prison keep seeing doctors, and it has a $28-million grant sponsored by the National Institutes of Health and others to help them.
Massachusetts' state government rolled out a new version of its prescription monitoring program, which will be easier for doctors to use and will allow data sharing between states. Gov. Charlie Baker also announced a new partnership among the state's teaching programs for nurses and physician assistants and with community health centers to teach medical practitioners about safe prescribing strategies for prescription drugs. The new prescription monitoring program is a revamped version of an old program, with easier-to-use technology.
In preparation to make recommendations to state officials that could serve as a national model for prioritizing patients in the event of a disaster, Dr. Lee Daugherty Biddison, a critical care physician at Johns Hopkins, and colleagues have listened as hundreds of citizens discuss whether a doctor could remove one patient from lifesaving equipment to make way for another who might have a better chance of recovering, or take age into consideration in setting priorities. At least 18 states from New York to California, and numerous hospitals have developed such protocols.
The Obama administration is moving to end duplicate coverage for tens of thousands of people who are enrolled in Medicaid and simultaneously receiving federal subsidies to help pay for private health insurance under the ACA. Consumers around the country received warning letters from the federal exchange telling them they "should immediately end marketplace coverage with premium tax credits for each person" in the household who is also enrolled in Medicaid or CHIP.
Beyond high cost, people with hepatitis C face several barriers to treatment from various sources including doctors, Medicaid, private health insurance companies and intravenous drug use, according to a study, led by Karen Clements, assistant professor of quantitative health sciences at UMass Medical School and a senior project director in Commonwealth Medicine.