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Public Health

Zohydro Ban: Disagreeing with Governor Patrick

April 16, 2014 by David E Williams

I agree with Governor Deval Patrick that opiate addiction is a huge problem in Massachusetts (and many other places). But the attempt to ban sales of Zohydro is a bad idea that’s likely to have a negligible impact on the addiction crisis, while potentially harming one of Massachusetts’ most important industries.[read more]

Bundled Payments: Rewarding Quality and Value

April 16, 2014 by Linda Ringquist

Transformation to bundled payments

The Medicare reimbursement system is in the process of transforming healthcare as we know it from a traditional fee-for-service model to a system that rewards based on quality, care coordination, accountability, and healthcare cost savings. Here's an outline of benefits and risks.[read more]

A New Era for the Public Healthcare Sector

April 15, 2014 by Siemens Healthcare

Gustavo Pulti, Mayor of General Pueyrredón Municipality

Beaches, fishing, and sweet pastries filled with dulce de leche were the hallmarks of Mar del Plata in the past. But now, the city – located on the Atlantic coast, about 400 kilometers south of the Argentine megacity of Buenos Aires – has a new trademark: the Centro de Especialidades Médicas Ambulatorias (CEMA).[read more]

Understanding RVUs | Medicare Reimbursement

April 14, 2014 by Linda Ringquist

Relative Value Units

Do you understand Relative Value Units (RVUs) as they relate to Medicare reimbursement? RVU stands for Relative Value Unit and is currently used by Medicare to determine the amount of reimbursement to providers. RVUs are basically a way of standardizing and comparing service volumes across all continuums.[read more]

CMS Medicare Data Dump Shows Why Transparency Is Only Half the Battle

April 14, 2014 by Deanna Pogorelc

Image: Flickr / Images Money

The government has said the public release of how $77 billion in federal dollars was doled out to more than 880,000 providers in 2012 through Medicare Part B services will give consumers insights to inform their healthcare decisions and potentially expose fraud. But the raw data doesn’t tell the whole story.[read more]

Medicare Advantage Cuts Not Only Delayed But Reversed

April 12, 2014 by Linda Ringquist

medicare / shutterstock

As of February 2014, Medicare Advantage reimbursement was set to be slashed by 1.9%. But CMS has reversed its original proposal to cutback Medicare Advantage plan reimbursement for 2015. The reversal is a result of aggressive lobbying from organizations such as the American Medical Association.[read more]

Dissecting Diabetes: Costs and Chronic Disease Impact

April 12, 2014 by Kenneth Thorpe

diabetes / shutterstock

Nearly 26 million Americans live with one of three types of diabetes – type 1, type 2 and gestational. The Centers for Disease Control and Prevention (CDC) estimates that if these trends continue, by 2050, one in three Americans will struggle with diabetes.[read more]

The Diagnosis That Could Have You Paying an Extra $40,000 Per Patient

April 10, 2014 by Abby Norman

hospital acquired infections

Common Hospital Acquired Infections, like pneumonia or urinary tract infections, are preventable with proper hand hygiene, isolation procedures and prophylactic antibiotics. Even so, these infections have the U.S. healthcare system paying more than $4.5 billion annually.[read more]

Should Step Therapy and Prior Authorization Be Outlawed?

April 9, 2014 by David E Williams

photo: torbakhopper / photopin cc

Step therapy and prior authorization are legitimate and even necessary tools. This doesn’t mean that these approaches shouldn’t be scrutinized. Balancing cost, quality, access and convenience in today’s healthcare system is not easy. Making things better requires something more than legislating further restrictions on health insurers.[read more]

Dual-Eligibility: An Overworked and Overlooked Population?

April 9, 2014 by Abby Norman

dual eligibility

9 million Americans are covered by both Medicare and Medicaid and are part of a unique community of healthcare consumers known as the dual eligible. Dual-eligible beneficiaries often have complex health conditions and may be low income, meaning that their access to healthcare would be greatly limited if not for their dual-eligibility for coverage.[read more]

Advancing Comprehensive Obesity Solutions Critical in the Fight Against Chronic Disease

April 8, 2014 by Kenneth Thorpe

obesity solutions / shutterstock

As providers and patients, policymakers and stakeholders alike, all still grapple with how to understand obesity as a disease, the recent announcement by the U.S. Office of Personnel Management (OPM) asserting drug therapy as a viable solution in the treatment of obesity, is another positive step forward in the fight against costly chronic disease.[read more]

Office of Recovery: Avellone Proposes Strong Response to Substance Abuse [TRANSCRIPT]

April 8, 2014 by David E Williams

Joe Avellone, Democratic candidate for Governor of MA

I recently had an opportunity to speak with Joe Avellone, Democratic candidate for Governor of Massachusetts. We had spoken previously about healthcare policy in general; this time, we spoke about substance abuse and why he was making it such a high priority issue in the campaign.[read more]