Monday, June 1, 2015
Federal Investigators Fault Medicare’s Reliance on Doctors for Pay Standards
The government relies too heavily on advice from the American Medical Association in deciding how much to pay doctors under Medicare, and the decisions may be biased because the doctors have potential conflicts of interest, federal investigators say in a new report. (Robert Pear/The New York Times)
Feds Unveil Long-Awaited Overhaul of Medicaid Managed Care
The federal government on Tuesday unveiled a long-awaited regulatory package that sets national standards for managed care under Medicaid, marking the biggest changes to the growing program in more than a decade. (Sarah Ferris/The Hill)
The CMS released three new sets of data Monday that detail how much hospitals billed and received for inpatient and outpatient services and how much Medicare paid physicians in 2013. As with the government's first release of the data last year, the numbers show wide variation. (Bob Herman/Modern Healthcare)
It's not yet clear whether the CMS' sweeping proposed rule governing Medicaid managed care will resolve the coverage and access problems facing the growing number of low-income adults and children enrolled in private Medicaid plans. But it's likely that there will be political jockeying over many of its provisions. (Virgil Dickson and Bob Herman/Modern Healthcare)
Hospitals are trying new early-warning systems to monitor patients for subtle but dangerous signs of a worsening condition.
After surgery or during hospitalization for illness, patients are at risk for complications that can quickly turn fatal, such as a depressed breathing rate that can lead to cardiac arrest caused by over-sedation or an adverse reaction to narcotic pain medications. Patients can show signs of deterioration—known in medical terms as “decompensation”—as many as six to eight hours ahead of a cardiac or respiratory arrest, studies show. (Laura Landro/The Wall Street Journal)
