Posts By: admin

Hospitals are beginning to look into outsourcing medical imaging to sophisticated computer controlled “artificial intelligence” (AI) programs.  While technology may provide lower costs by increasing quality of care and provider efficiency, there are still plenty of road blocks to overcome.  Radiologists should not worry just yet.  They are still necessary to interpret the information that computers produce.  Without someone to make sense of the data, it is useless. By use of AI and machine-learning algorithms, the idea is for these new computers to find patterns in images and identify specific markers that the human eye cannot catch.  Early trials have…
Learn More

The new CMS rule, aimed at improving the quality of home health agency patient care, has been delayed.  This rule requires additional training for Home Health Agency staff and administrators.  It also expands coordination of care assistance for these patients. The rule was previously set to go into effect on July 13, 2017.  The new effective date is January 13, 2018. “Industry stakeholders” asked CMS for more time to complete the additional training to meet the rule requirements.  Some additional changes to the rule are outlined in the attached Modern Healthcare Article:  Read Article   Published by:  Modern Healthcare: By…
Learn More

CMS released two reports in June that indicate high costs and lack of affordability are the most common factors that lead to consumers cancelling their health care.  For more details on their findings, visit this link to read the reports  CMS Press Releases   Press Release By:  CMS:  June 12, 2017  

In an interesting article by Robert Lowes (Medscape), he discusses recent Merritt Hawkins survey results on the topic of Volume vs Value in Physician Pay.  One of the main reasons the new “Value-based Pay” was put into place was to “pump up the volume of services” for Providers resulting in greater revenue in conjunction with providing better “value” to the patients.  A recent survey, by recruiting firm Merritt Hawkins, suggests that the old Fee-for-Service model is still more the norm.  The Survey suggests that Value-based pay is not yet an effective incentive for Doctors to change they way they practice…
Learn More

Yesterday, in Modern Healthcare news, we learned that “CMS may have mistakenly made $729 million in EHR Payments”.  The HHS’ Office of the Inspector General reports that incentive payments may have gone to about 500,000 providers that did not meet the federal standards of the HITECH Act .  CMS Documentation review requirements were minimal relying on self-reporting from providers.  This opened the program to abuse according the the inspector General. The inspector general recommends that CMS should do their own investigation and pursue repayment from providers that received over payments.  June 12, 2017 Modern Healthcare Article Published by:  Modern Healthcare: by Virgil…
Learn More

Amazon, “That familiar smiling brown box” has its eye on the Medical Supply Industry.  Amazon is rapidly increasing their seller base by expanding their Amazon Business Platform.  What does this mean for medical supply distributors? Amazon’s reliable track record for great service and low costs kills the ability for many other businesses to compete.  Full Modern Healthcare Article   Published by:  Modern Healthcare:  By Alex Kacik June 10, 2017  

According to this recent Modern Healthcare article, the Medicare Access and CHIP Reauthorization Act (MACRA) could cause hospitals to lose $250 billion in reimbursements over a 15-year period.  The new payment models may cause a reduction in hospital admissions and hence a “slump in Medicare reimbursements”.  With a projected overall reduction in Physician reimbursements by $47 billion from 2015 to 2030, how will Physicians recover?  More importantly, authors caution that “if successful APMs are not available to physicians, there could be unintended consequences for patients, and one of the key goals of MACRA will be missed.” Read Modern Health Article…
Learn More

With so many buried and complicated tax rules, deductions for businesses and individuals, how is it possible for the Trump administration to think they will have tax reform in place by August 2017?  With no current tax reform bill in place at this time, what will Trump negotiate with Congress?  The President promised during is campaign to “slash the corporate tax rate from 35 percent to 15 percent, and lower the top individual rate from 39.6 to 33 percent with fewer brackets”.  Will Trump go for straight tax cuts and deductions hoping to lower rates, or will he attempt to tackle…
Learn More

In the first quarter of 2017, UnitedHealth Group, the nation’s largest health insurance provider reported a 9.4% increase in revenue when compared to the same time frame last year.  What has changed?  They “bailed” on the majority of the ACA health insurance exchanges in 2017.  After reporting more than a $1 billion loss on the exchanges in 2015 and 2016, UnitedHealth reduced their ACA footprint from 34 states to only a handful remaining this year.  Other national providers are following UnitedHealth’s lead by scaling back on their ACA plans as well.  Read more:  Full Modern Healthcare article Published by:  Modern…
Learn More

This blog ties back to the previous blog just posted:  Commercial Carriers losing big on “The Exchange”.  Many news articles and reports support the opinion that individual health markets in some states are “in an emergency condition”.  Some states (I.e. Tennessee) have three quarters of their counties without one insurance company offering plans on the Exchange.  Considering our previous blog (mentioned above), is there any wonder why Insurance companies, such as Humana, are pulling out of The Exchange? Republicans are introducing ACA replacement plans due to what they refer to an ACA “death spiral”, while Democrats insist that the system has been working.  Some Democrats believe that GOP interference has…
Learn More