Formerly vice president and CFO at Sharp Metropolitan Medical Campus, part of San Diego-based Sharp Healthcare, Cornicelli says Phoenix Children's is at an inflection point.
After spending 22 years at Sharp, Cornicelli joined Phoenix Children's...
The Flagstaff-based Arizona regional health system announced a partnership with California-based Omnicell to use the pharmaceutical technology company’s automation and intelligence software to enhance the efficiency and safety of medicine management at flagship hospitals Flagstaff Medical Center and Verde Valley Medical...
A proposed rule from the Centers for Medicare and Medicaid Services (CMS) last week would increase home health payments and eliminate a quality measure from the reporting program.
Net payments would increase by $250 million in 2020, or 1.3 percent, to ensure that home health payments remain consistent with current year statutory...
Skilled nursing facilities can't require residents to sign an arbitration agreement prior to admission nor can they include language in such an agreement that would bar residents from contacting federal, state or local authorities - but they can now offer binding arbitration agreements to patients and caregivers.
The proposed rule...
A cross-sectional study of 620 ACOs which had 40-45 percent of patient visits provided by specialists had statistically significantly lower per-beneficiary person-year spending compared with ACOs with fewer visits done by specialists.
The authors concluded that ACOs providing 40 percent to less than 45 percent of office visits through...
Insurance giant Aetna announces a partnership with caregiver marketplace CareLinx to give its Medicare beneficiaries access to a national caregiver network providing at-home caregiver services as a benefit under its 2019 individual Medicare Advantage (MA) plans.
The partnership is currently only relevant to Aetna Medicare members...
Sen. Bernie Sanders took another blow to his controversial single-payer proposal “Medicare-for-All” as presidential candidate front-runner Joe Biden unsurprisingly shows solidarity with Obama by offering an expansion of the Affordable Care Act as a government healthcare solution.
On paper, Biden’s plan is significantly more...
Last week, CMS announced two new voluntary models and proposed regulations for two mandatory models in response to President Trump's Advancing American Kidney Health executive order.
The Center for Medicare and Medicaid Innovation (CMMI) payment models are designed to transform kidney care so Medicare beneficiaries with end stage...
MA insurers have consistently pushed back on the agency's use of Risk Adjustment Data Validation (RADV) audits to curb what the agency says is $30 billion in undeserved payments during the past three years.
According to reporting from Kaiser Health News, CMS didn't perform audits for payments made during 2008, 2009 and 2010 because of...
CMS released preliminary second-year participation data for the Quality Payment Program on July 11; includes 2017-2018 year-over-year data comparisons.
According to the agency, participation in Advanced APMs increased from 99,076 to 183,306 clinicians from 2017-2018. Eligible clinicians receive a five percent APM incentive payment...
Provider directories for Medicare Advantage (MA), the private alternative to traditional fee-for-service Medicare, have historically shown to be highly unreliable and audits performed by the Centers for Medicare and Medicaid Services (CMS) reinforced that notion by reporting inaccuracies in nearly half of all MA online provider...
The plan would have detoured drug rebates from insurers and PBMs to Medicare beneficiaries at the pharmacy counter, but after the Congressional Budget Office predicted it would increase Medicare spending by around $177 billion over a decade and could lead to higher premiums, the administration scrapped the plan.
Americans learned of...
A panel of three federal judges for the Fifth Circuit Court of Appeals heard 90 minutes of oral arguments on Tuesday defending or refuting a Texas district judges ruling of the Affordable Care Act (ACA) as unconstitutional in December. Millions of Americans depending on the ACA for healthcare are at risk of losing coverage if the...
The state's inmate lawsuit filed in 2012 is far from a case-closed as attorneys remain unsatisfied with Arizona prison healthcare conditions and request an additional round of contempt-of-court fines for the state's continued failure to comply with settlement requirements.
According to an AP News story, attorneys challenging the...
It promises greater drug price transparency and improved patient adherence to prescriptions. Get the basics of RTB, what problems it solves, and how its growing in popularity in this white paper from SSC Health.
Our research concluded that where SS&C Health RTB responses resulted in both a prescription and a paid...
Participating in public health policy and navigating the legislative process is for everyone, if you know the steps. This podcast gives you the tools.
Master the policy process with Arizona Common Ground, an eight episode educational podcast series that gives a behind the scenes glimpse of the state legislative system to familiarize...
The Trump administration has raised the volume on drug prices but while the court said it can't force manufactures to list their prices, Trump is expected to pen an executive order to tie Medicare drug prices to those of other countries.
Following the Fourth of July festivities, President Trump said he would be announcing something...
Funding tax-free health reimbursement arrangements (HRAs) as an alternative to providing health coverage gives employers another option for helping employees get coverage; employees can use HRAs to purchase individual market insurance.
The Departments of Health and Human Services, Labor and Treasury estimate about 800,000 employers...
Ramona Ramadas, nurse and current graduate student at the Arizona State University Edson College of Nursing and Health Innovation, accumulated over $60,000 in funding for her healthcare venture, aiming to address social and behavioral healthcare deficiencies, through pitch competitions.
Ramadas recognized a gap in healthcare...
The U.S. Department of Health and Human Services Office of Inspector General (OIG) analyzed data from more than 4,500 hospices participating in Medicare and found 80 percent had a deficiency, 20 percent had one or more serious deficiencies, a third had complaints filed against them and more than 300 were poor performers. The most recent...
Los Angeles-based CHA Hollywood Presbyterian Medical Center (HPMC), a subsidiary of CHA Medical Group, was accepted to participate as part of the first cohort of hospitals to improve quality of care in Medicare’s BPCI-A initiative.
HPMC has designed and implemented a continuing care program that continues to provide...
Arizona's Medicaid agency, the Arizona Health Care Cost Containment System (AHCCCS), published its first "At A Glance" infographic in June. The agency offers this visual snapshot that includes its quarterly enrollment numbers, behavioral health services usage and details the impact of programs addressing the state's opioid crisis.
...
After last week's Democratic debate, it became evident the party is divided on healthcare policy, most notably Medicare-for-All. Only a few presidential hopefuls raised a hand when asked if ready and willing to eliminate private insurance, despite others on stage having previously voiced their support for Sen. Bernie Sanders'...
The lawsuit calling into question the Affordable Care Act's (ACA) constitutionality brought on by 20 red state attorneys general has made its way back into the limelight after the Fifth Circuit Court of Appeals asked parties involved in Texas v. United States to address three questions sent out by the office of the clerk last...
Despite efforts from the Centers for Medicare and Medicaid Services (CMS) to curb hospital readmission for traditional fee-for-service Medicare, a new study suggests Medicare Advantage (MA) enrollees are showing higher rates.
CMS only factors in fee-for-service Medicare user data when calculating readmission rates and does not...
