CMS Looking At Quality Metrics To Get ACA Exchange Plans Into Value-Based Care

Affordable Care Act (ACA) marketplace officials are hoping to get more plans into value-based care arrangements as regulators hope to not just build on getting people covered, according to federal officials. Officials with the Centers for Medicare & Medicaid Services (CMS) spoke Thursday at the Health Care Payment Learning and Action Network Summit on value-based ...

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More People Will Be Eligible For Health Insurance Through Covered California

Hundreds of thousands of Californians previously shut out of Covered California — the state program that offers discounted health insurance — soon can participate because the eligibility requirements are changing. Prior to the new rules, individuals who had access to an employer-based health insurance plan through a family member were not eligible for Covered California. Employer plans ...

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Californians Reject Measure To Alter Dialysis Clinic Rules

For the third time in three straight elections, California voters rejected a ballot measure that would have mandated major changes to the operations of dialysis clinics that provide life-saving care to 80,000 people with kidney failure. Proposition 29 failed after nearly 70% of Californians voted “no” in returns late Tuesday. The measure would have required ...

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Exclusive: Russian Software Disguised As American Finds Its Way Into U.S. Army, CDC Apps

Thousands of smartphone applications in Apple (AAPL.O) and Google’s (GOOGL.O) online stores contain computer code developed by a technology company, Pushwoosh, that presents itself as based in the United States, but is actually Russian, Reuters has found. The Centers for Disease Control and Prevention (CDC), the United States’ main agency for fighting major health threats, said it had been ...

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AI Algorithms, Strict Place-of-Work Rules Potential Trouble Spots for Employment Claims

Technological innovations and changing work arrangements brought on by the COVID-19 pandemic are among some of the emerging issues that can make employers vulnerable to discrimination lawsuits, a top employment practices defense attorney said Thursday. Barry A. Hartstein, co-chair of the Equal Employment Opportunity & Diversity Practice for the Littler Mendelson law firm in Chicago, ...

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A Post-Election Conversation with NAHU’s Janet Trautwein

Paul Roberts, Word & Brown’s Senior Director of Education and Market Development, hosted a conversation this week with Janet Trautwein, CEO of the National Association of Health Underwriters (NAHU) and President of the NAHU Education Foundation, concerning the November 2022 election.

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Open Enrollment Starts For Nevada’s Health Insurance Exchange

Those eligible to purchase insurance through the Silver State Health Insurance Exchange include independent contractors and gig workers, those whose employers don’t offer insurance and others for whom premiums would take too big a bite out of their paychecks.

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Prices For The Same Scan At The Same Hospital Can Range From $134 To $4,065: Study

When it comes to price negotiations for healthcare services between hospitals and insurance companies or self-insured employers, hospitals appear to be winning big time, according to a study in Radiology.

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COVID-19 Cases, Hospitalizations Rise Significantly In State, Clark County

COVID-19 cases and hospitalizations have risen significantly in the past week statewide and in Clark County, but still remain relatively low, according to new data released Wednesday. Confirmed and suspected hospitalizations increased by 65 percent to 209 in Clark County, and by 56 percent to 256 statewide, according to data from the Nevada Department of ...

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'Well-Intentioned, Poorly Executed Waste': How Tech Companies Aim To Reduce Billions In Wasteful Spending

Last year, the estimated Medicare fee-for-service improper payment rate was more than 6%, representing more than $25 billion in improper payments. Despite the historic low, the rate rose in some areas like skilled nursing facilities. Managing claims is difficult and complex. One recent study found that nearly a third of healthcare resources are tied up in administrative costs, taking focus away ...

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