Health care-insurance giant Aetna has agreed to acquire smaller rival Humana for $37 billion in cash and stock making it the largest ever deal in the insurance industry. The rapid consolidation in the U.S. health care industry. brings together Humana’s growing Medicare Advantage business with Aetna’s diversified portfolio and commercial capabilities to create a company serving the most seniors in the Medicare Advantage program and the second-largest managed care company in the nation.
Under
Read More
Healthcare Policy Regulation & Reform | News, Analysis, Insights - HIT Consultant
Why Non-Specific ICD-10 Codes Are a Non-Issue
A safe harbor or grace period that would allow the submission of “less specific” ICD-10 codes after the ICD-10 transition continues to be raised as a way to alleviate the burden of the transition on physicians. For example, HR 2247, the ICD-TEN Act, would prohibit Medicare from denying claims “due solely to the use of an unspecified or inaccurate subcode.” A letter to the Centers for Medicare & Medicaid Services (CMS) from several members of Congress recommends that CMS indicate “whether
Read More
Florida’s PremierMD ACO Selects eClinicalWorks for Population Health Management
Florida’s PremierMD ACO LLC (Premier), an ACO participating in the Medicare Shared Savings Program, has chosen the eClinicalWorks CCMR population health platform to advance its ACO objectives, coordinate care across the continuum as well as evaluate population health and quality improvement activities. eClinicalWorks will also be the preferred EHR solution for the organization.
Premier participates in the Medicare Shared Savings Program, which has been created by the Centers for Medicare
Read More
King v. Burwell: 5 Key Trends Driving Consumer-Focused New Health Economy
Today, the Supreme Court affirmed the 4th Circuit, holding that tax credits are available in states using the federal exchange. PwC's Health Research Institute (HRI) performed an analysis of publicly available information - including ACA enrollment data and CMS data on hospital spending - to assess the financial impact of the loss of subsidies in the federal marketplace. The Court’s decision in King v. Burwell removes uncertainty for some 8 million Americans who were at risk of losing coverage
Read More
3M Unveils Health System Performance Suite for PHM
As hospitals and health systems navigate the journey from volume- to value-based health care, 3M Health Information Systems is applying the analytic power of its extensive clinical and claims database to help providers assess the costs, outcomes and effectiveness of care delivery. The new 3M Health System Performance Suite offers advanced analytic tools to manage the health of populations, measure provider performance, determine total cost of care and succeed under value-based
Read More
AHIMA Recognized for ICD-10 Grassroots Advocacy Program
The American Health Information Management Association (AHIMA) was recognized for its ICD-10 grassroots advocacy program as the recipient of a Silver Award in the 2015 Power of A Awards, sponsored by the American Society of Association Executives (ASAE). Each year ASAE recognizes and celebrates the extraordinary contributions associations make to society by enriching lives, creating a competitive workforce, preparing society for the future, driving innovation and making a better world.
AHIMA
Read More
Infographic: Why Implement ICD-10?
As healthcare trade groups and certain members of Congress continue to advocate against the implementation of ICD-10-CM/PCS, AHIMA has create the following infographic to illustrate the importance of ICD-10 and its long term benefits for the healthcare industry.
Read More
Do We Really Understand Documentation Requirements for ICD-10 PCS?
Editor's Note: Dr. Jon Elion is the founder and CEO of ChartWise Medical Systems, He is a practicing board-certified cardiologist in Providence, RI and an Associate Professor of Medicine at Brown University.
After decades of experience with ICD-9, we have learned and come to grips with its quirks. We do not yet have that comfort level with ICD-10 -- after all, it’s still pretty new to most of us in the U.S. I’m not really concerned about the diagnosis side of ICD-10 and its Clinical
Read More
6 Reasons Why ICD-10 Safe Harbor Is Dangerous for Healthcare Delivery
Editor's Note: The Coalition for ICD-10 has issued the following statement in response to the recent efforts to create a "safe harbor" for physicians, which would prohibit claims from being denied due to incorrect or unspecified ICD-10 codes, will result in dangerous consequences for the healthcare delivery system.
Multiple bills have been introduced in Congress that create a “safe harbor” for physicians by prohibiting claims from being denied “due solely to the use of an unspecified or
Read More
WEDI Opens ICD-10 Readiness Survey to Gauge Industry Progress
On Thursday, The Workgroup for Electronic Data Interchange (WEDI) announced the release of its latest ICD-10 readiness survey to help determine how prepared the healthcare industry is prepared for the upcoming Oct. 1, 2015 compliance deadline. With less than 111 days left , providers, health plans, vendors and clearinghouses are invited to participate in this important initiative to help gauge progress for all parties.
With the implementation deadline fast approaching, providers,
Read More
