Healthcare Financial News

A new report from the Robert Wood Johnson Foundation finds that privately insured patients account for the largest and fastest growing segment of emergency department (ED) users. And expansion of health insurance coverage on its own is likely to increase rather than decrease stress on overcrowded EDs, the authors conclude. The report, Emergency Department Utilization and Capacity, recommends aligning reimbursement incentives to improve hospital patient flow and reduce ED overcrowding. The authors also highlight the need to improve access to primary care, either through community providers or through delivery of primary care in the ED.

Download the report.

The inability to arrange for follow-up care for uninsured patients is a growing problem with significant effects on ED physician practice patterns and patient outcomes, according to a new report from the Kaiser Family Foundation. Emergency Departments Under Growing Pressure is based on interviews with practicing clinicians that explore the impact of the recession on hospital EDs as patient volume increases and health coverage declines.

Another new Kaiser report, Struggling With Financing: The Recession and National Health Reform Dominate State Medicaid Concerns Going into FY 2010, draws on interviews with state Medicaid directors, discusses the prospect of significant Medicaid cuts in some states, shows how federal stimulus money has been helpful but still leaves states trying to cope with budget shortfalls, and examines how state Medicaid directors see federal health reform affecting their programs. In addition, Kaiser has updated a fact sheet that examines state fiscal conditions and Medicaid.

The Medicare recovery audit contractor (RAC) for Region C, Connolly Healthcare, has posted the first set of issues eligible for RAC review. Demand letters notifying providers of coding errors and claim amounts will follow. These issues are approved for outpatient hospital and physician providers in South Carolina.

The other states and territories in RAC Region C are: Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, North Carolina, New Mexico, Oklahoma, South Carolina, Tennessee, Texas, Virginia, West Virginia, Puerto Rico, and the U.S. Virgin Islands.

A new report from the State Alliance for e-Health, Preparing to Implement HITECH: A State Guide for Electronic Health Information Exchange, aims to help states implement the federal Health Information Technology for Economic and Clinical Health (HITECH) Act.

The report recommends that states prepare or update their plan for adoptng health information exchange; engage stakeholders in planning efforts; establish a state leadership office; implement privacy strategies and reforms; determine a business model for health information exchange, and create opportunities for training and education.

The HITECH Act, enacted as part of the 2009 American Recovery and Reinvestment Act, expands the role of states in fostering health information exchange and adoption of electronic health records over the next five years.

The State Alliance for e-Health, composed of governors, state legislators, attorney generals and state commissioners, was created by the National Governors Association in 2006.