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Private insurers, employee wellness programs seek to control costs

Modern Healthcare: "Private insurers may be better at controlling healthcare costs than Medicare, according to a Health Affairs study of two Texas cities. The study is a follow-up to a widely read 2009 New Yorker article by Atul Gawande that showed per-capita Medicare spending in McAllen, Texas, was 86% higher than in El Paso.

8 Dec 2010

Neurologist wins trial for defamation against Utah Medicaid Fraud Control Unit

The worst abuses in government health programs may be by officials who press false charges. Threatening criminal prosecution to try to get a physician to pay monies amounts to "extortion," admitted one prosecutor in sworn testimony published in the winter 2010 issue of the Journal of American Physicians and Surgeons (http://www.jpands.org/vol15no4/becker.pdf).

8 Dec 2010

MedeAnalytics introduces Accountable Care Solution for healthcare provider and payer organizations

MedeAnalytics, a leading provider of healthcare performance management solutions, today announced the launch of its Accountable Care Solution for healthcare provider and payer organizations.

8 Dec 2010

First Edition: December 8, 2010

Today's health policy headlines include more detail on the deal reached to avoid a scheduled cut in physician's Medicare pay.

8 Dec 2010

Private insurers more effective in controlling health care spending than Medicare

Private insurers appear to be more effective in controlling health care spending differences between two Texas cities than Medicare, according to researchers from The University of Texas Health Science Center at Houston (UTHealth) School of Public Health. Researchers found that sharp disparities in per-capita Medicare healthcare spending between McAllen and El Paso were significantly diminished when private insurance paid for health care costs in the under-65 population.

8 Dec 2010

Almost Family enters new 5-year $125 million revolving credit facility

Almost Family, Inc., a leading regional provider of home health nursing services, announced today it has entered into a new five-year $125 million revolving credit facility that increases its financial flexibility through 2015 (the Facility). J.P. Morgan Securities LLC acted as sole bookrunner and sole lead arranger, while Bank of America, N.A. acted as syndication agent under the Facility which replaced the Company's previous $75 million credit facility.

8 Dec 2010

Study examines impact of poor care coordination on quality, cost of care in America

Many Americans seek medical treatment from a variety of care providers and often must play the role of informing each doctor what the others are recommending or prescribing. This fragmented experience of poorly coordinated care is due in part to a lack of consistent systems and processes in place to coordinate care across providers and facilities.

8 Dec 2010

New Health Affairs study reexamines cost issues related to care in McAllen and El Paso

"Did McAllen get a bum rap? McAllen, Texas, spends more on Medicare patients than almost any other part of the country. A June 2009 New Yorker article by Atul Gawande attributed the high spending to a culture of doctors that 'came to treat patients the way sub-prime mortgage lenders treated home buyers: as profit centers.' The article became required reading in the White House and Congress during the health care debate and turned McAllen into shorthand for America's decadent medical spending problem."

8 Dec 2010

Issues in health delivery: Hospital-spread infections; Finger-prick blood tests for diabetes; Medicare spent millions on unnecessary stents

News outlets report on a variety of issues and developments related to quality of care and health delivery systems.

8 Dec 2010

Some in health industry raising concerns about Accountable Care Organizations

CQ HealthBeat: "The medical device industry told the Centers for Medicare and Medicaid Services that it's concerned about whether accountable care organizations could give providers financial incentives to hold back on needed patient care, particularly on technology. Meanwhile, insurance plan executives warned CMS officials that the ACOs could give hospitals and doctors new bargaining leverage in negotiations with insurers.

8 Dec 2010

Company reaches $28 million settlement for Medicare program

The Tennesseean: "Healthways Inc. will return $28 million to Medicare's overseer under a settlement related to the company's participation in a pilot program to determine the effectiveness of its nurse-based health coaching for chronically ill seniors." The Centers for Medicare and Medicaid Services had paid the company $72 million for the pilot program, which ended two years ago, under the condition that it meet "specific targets for cost savings, health outcomes and patient satisfaction."

7 Dec 2010

Deal for year-long doc fix in the works

Politico: Senators reached a tentative deal Monday that would tap health law funds to avert a scheduled pay cut for physicians. The deal would take back about $19.2 billion in health law subsidies to help people buy health insurance beginning in 2014. It "would change how much money consumers would have to repay if their income status changes mid-year, pushing them out of the eligibility bracket.

7 Dec 2010

IASIS Healthcare fourth quarter net revenue increases 1.6% to $629.9 million

IASIS Healthcare LLC today announced financial and operating results for the fiscal fourth quarter and year ended September 30, 2010.

7 Dec 2010

Watson, Natco confirm development agreement for generic Revlimid

Watson Pharmaceuticals, Inc. and Natco Pharma Limited today confirmed an exclusive, U.S. development and license agreement, to develop and commercialize lenalidomide 5, 10, 15 and 25 mg tablets. The companies also confirmed that Natco has filed an Abbreviated New Drug Application (ANDA) with the U.S. Food and Drug Administration (FDA) seeking approval to market its lenalidomide 5, 10, 15 and 25 mg product. Natco's lenalidomide tablets are generic versions of Celgene's Revlimid ® Tablets.

7 Dec 2010

First Edition: December 7, 2010

In today's headlines, Senate leaders appear to be nearing a one-year deal on Medicare's physician pay problem.

7 Dec 2010

Early physical therapy associated with fewer subsequent injections, surgery, physician visits: Study

The American Physical Therapy Association is pointing to a new study on low back pain in Medicare patients in its efforts to encourage the newly established Center for Medicare and Medicaid Innovation to promptly launch a demonstration project on direct access to physical therapist services that was recommended in the recent health reform law.

7 Dec 2010

Research roundup: Early retiree insurance; high deductible plans and skipped care; innovation and FDA

Health Care Use And Decision Making Among Lower-Income Families In High-Deductible Health Plans - This study examines the health care experiences of lower-income families (those with incomes that were less than 300% of the federal poverty level) with high-deductible health plans (HDHPs) compared to higher-income families.

7 Dec 2010

Report: Baltimore cardiologist inserted 'medically unnecessary' stents

Abbott Laboratories, a $30 billion-a-year, Chicago-based pharmaceutical firm, ranked [Dr. Mark] Midei among its top-volume doctors in the Northeast and made plying him with research money and 'VIP trips' part of its business plan in late 2008 — about the time Midei's usage of Abbott-brand stents soared, the report said.

7 Dec 2010

AARP survey shows overwhelming support for long term solution to protect access to medicare doctors

Access to doctors is critical to 39 million older Americans on Medicare – including over 1.5 million Illinoisans. But this access might be gravely compromised if Congress takes no action by January 1st, 2011, to prevent a severe cut in pay for Medicare physicians. Today, AARP released a survey of Illinois members, showing overwhelming support for a long term solution that protects patients' access to their doctors.

7 Dec 2010

Today's Op-Eds: ObamaCare and FEHBP; California prisons; and workhorse Medicaid

Even Washington's stupidest scandals can be revealing, and so it is with the liberal cri de snore that Republicans ought to renounce health insurance. Democrats have inadvertently drawn up another indictment of ObamaCare (12/4).

6 Dec 2010

Medicare News and Research

Private insurers, employee wellness programs seek to control costs

Neurologist wins trial for defamation against Utah Medicaid Fraud Control Unit

MedeAnalytics introduces Accountable Care Solution for healthcare provider and payer organizations

First Edition: December 8, 2010

Private insurers more effective in controlling health care spending than Medicare

Almost Family enters new 5-year $125 million revolving credit facility

Study examines impact of poor care coordination on quality, cost of care in America

New Health Affairs study reexamines cost issues related to care in McAllen and El Paso

Issues in health delivery: Hospital-spread infections; Finger-prick blood tests for diabetes; Medicare spent millions on unnecessary stents

Some in health industry raising concerns about Accountable Care Organizations

Company reaches $28 million settlement for Medicare program

Deal for year-long doc fix in the works

IASIS Healthcare fourth quarter net revenue increases 1.6% to $629.9 million

Watson, Natco confirm development agreement for generic Revlimid

First Edition: December 7, 2010

Early physical therapy associated with fewer subsequent injections, surgery, physician visits: Study

Research roundup: Early retiree insurance; high deductible plans and skipped care; innovation and FDA

Report: Baltimore cardiologist inserted 'medically unnecessary' stents

AARP survey shows overwhelming support for long term solution to protect access to medicare doctors

Today's Op-Eds: ObamaCare and FEHBP; California prisons; and workhorse Medicaid

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