By Susan Jaffe – Despite interventions by Medicare officials, the number of appeals from health care providers and patients challenging denied claims continues to spiral, increasing the backlog of cases and delaying many decisions well beyond the timeframes set by law, according to a government study released on June 9th.
By Jordan Rau – Over the past decade, the federal government has publicized 115 different ways to measure medical quality in hospitals, from assessing wait times in emergency rooms and noise levels outside hospital rooms to tracking blood clots in surgical patients. But the latest effort, to combine dozens of metrics into one patient-friendly quality indicator, has proven the most contentious.
By Susan Jaffe – Looking for ways to save money and improve care, Medicare officials are returning to an old-fashioned idea: house calls. But the experiment, called Independence at Home, is more than a nostalgic throwback to the way medicine was practiced decades ago when the doctor arrived at the patient’s door carrying a big black bag.
By Jordan Rau – The federal government paid bonuses to 231 hospitals with subpar quality because their patients tend to be less expensive for Medicare, new research shows. The bonuses are small, generally a fraction of a percent of their Medicare payments. Nonetheless, rewarding hospitals of mediocre quality was hardly the stated goal…
By Sandra G. Boodman – After James Happli of Mosinee, Wisconsin, was diagnosed with pancreatic cancer, he was referred to a surgeon at a local hospital where he had been treated for lymphoma 28 years earlier. The surgeon told Happli and his wife that although she had never successfully performed a Whipple procedure.
By Shefali Luthra – When it comes to hospitals, which benefit most from high health care prices? It may sound counter-intuitive, but a group of not-for-profit hospitals appear to be among those doing the best business.
By Ana B. Ibarra & David Gorn – Moving into a realm usually reserved for health care regulators, the California health marketplace unveiled sweeping reforms to its contracts with insurers, seeking to improve the quality of care, curb its cost and increase transparency for consumers.
By Mary Agnes Carey – As the health law turned six, federal officials proposed the expansion of a Medicare diabetes prevention program funded by the landmark measure. The pilot program, developed and administered by the YMCA…
By Phil Galewitz – She didn’t want to spend the rest of her days seeing doctors, the 91-year-old woman confessed to Dr. Kevin Newfield as he treated a deep wound on her arm. “You don’t have to, but you have to tell me what you do want,” Newfield replied. “I’m not afraid of dying. I’m afraid of being 106,” she told the surgeon and her daughter, who was in the room with them.
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