Patients who go to a poorly performing hospital have a 50% higher chance of dying from a preventable error than those who choose one earning an “A” on the Leapfrog Group‘s newest safety report card. If all US hospitals would improve to the “A” level, 33,000 lives could be saved annually.
Read MoreThe Centers for Medicare and Medicaid Services (CMS) continues to focus detection and enforcement efforts on Fraud, Waste and Abuse by taking aim in 2016 for a variety of CMS priorities. CMS continues to utilize data analytics and algorithms in “addressing the full spectrum of program integrity issues, in taking swift administrative actions, and in the performance of audits, investigations and payment oversight”. Healthcare organizations must remain diligent in their efforts to prevent Fraud, Waste and Abuses through education and compliance oversight programs.
Read MoreResearch now suggests that the savings the Affordable Care Act creates by revising the government payment to Medicare may also bring some harm to patients.
Read MoreHumana will distribute $77.2 million in bonus payments to roughly 3,700 physician groups nationwide who were engaged in its Provider Quality Rewards Program in 2014. The goal is to increase the 59% of Humana individual Medicare Advantage members who have primary care physicians participating in value-based relationships, to 75% by the end of 2017.
Read MoreCMS has been proposing changes in reimbursement for a number of established molecular diagnostic tests provided by CareDx. According to its CEO Peter Maag, the company is urging the CMS to keep the current reimbursement price for AlloMap, a heart transplant blood test, that is currently used by 110 of 130 transplant centers in the United States.
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