How paramedics helped BlueCross BlueShield of New Mexico reduce ER usage, readmissions

From what BlueCross BlueShield of New Mexico has found, establishing a partnership with community paramedics is not only good medicine, it’s good for business.   The insurer’s Community Paramedicine program, which started out as a pilot project in the fall of 2015, is targeted at Medicaid members who have either been identified as […]

Blue Cross NC taps CMS’ chief medical officer Conway as new president

Dr. Patrick Conway, the CMS’ chief medical officer, is headed to work for Blue Cross and Blue Shield of North Carolina as its president and CEO, starting Oct. 1. The insurer’s current president and CEO Brad Wilson, who is retiring, will remain in his role “for an appropriate period to […]

The worst state in the country for healthcare

While the United States ranks dead last in quality among 11 wealthy nations, a new report reveals that Louisiana is the worst state for healthcare overall. The Pelican State has one of the highest rates of heart disease in the country, the third highest cancer rate and a significantly low […]

Providers warn Anthem’s ER policy may violate federal law

Anthem is rolling out restrictions on what it will cover for emergency room visits, but providers worry that the policy could cause patients with potentially life-threatening conditions to avoid care—and that the hard-line approach could violate federal law. Anthem has deployed a reduced ER coverage policy in several of its […]

CMS’ final IPPS rule for 2018: 10 things to know

CMS has issued its Inpatient Prospective Payment System final rule for fiscal year 2018, which increases payments to acute care hospitals next year. The 2,456-page rule also includes proposed rates for long-term care hospitals. Overall, the final rule applies to about 3,330 acute care hospitals and 420 long-term care hospitals. […]

KKR to buy WebMD for $2.8 billion

Kohlberg Kravis Roberts & Co., the private equity giant that sold most of its stock in HCA a year ago, agreed Monday to acquire WebMD for about $2.8 billion, KKR announced Monday. KKR is paying $66.50 per share for publicly traded WebMD, a 20% premium over WebMD’s closing price Friday […]

CMS looks to launch behavioral health pay model

  The CMS is interested in launching a new pay model that will target behavioral health services and is seeking public comment on what the new effort should look like. On Thursday, the CMS announced that its Innovation Center would like to design a payment or service delivery model to […]

Rural patients face long waits for paramedics to arrive

Patients in rural areas face long waits for paramedics to arrive, according to a new study. Researchers reviewed data on more than 1.7 million emergency medical services runs from 485 agencies in 2015 and found that 1 in 10 rural patients waited half an hour for emergency personnel to arrive. […]

When it comes to healthcare, U.S. once again ranks last in quality care compared to other wealthy nations

A new Commonwealth Fund report finds the U.S. has the highest costs and lowest overall performance compared to Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United Kingdom. The United States spends more on healthcare than other wealthy nations, yet ranks dead last on […]

In Senate Health Care Bill, A Few Hidden Surprises

A low-income person, eligible for Medicaid but not enrolled, is hit by a car or a bullet. Gravely injured, she arrives at the hospital unconscious. Thanks to expert, intensive care that lasts for days or weeks, she gradually recovers. Eventually, her health improves to the point where she can complete […]