Health Insurers Tackle Deluge of Changes
Reform Regulations Are Kicking In Already
Healthcare reform requires changes of all stakeholders, but probably none more so than third-party payers, usually portrayed as wearing the black hat in this ongoing drama. In fact, President Obama hasn’t hesitated to cast insurers in the role of characters more worried about money than patient care.
SHARON H. FITZGERALD |
Keeping Score
As pay for performance (P4P) is expanded by Medicare, many commercial insurance companies are jumping on the bandwagon as well. P4P or value-based purchasing is a payment model that rewards physicians, hospitals, medical groups and other healthcare providers for meeting certain performance measures for quality and efficiency. As with Medicare, many commercial insurance companies also are looking to tie reimbursement and, in some models, rewards to these quality measurements.
SUZANNE BOYD |
St. Jude Breakthrough Update
Pediatric Research Shows Early Promise against Medulloblastomas, Link to Increased Malignant Tumor Risk, AML Survival Improvement
At the 46th annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago earlier this summer, researchers from St. Jude Children's Research Hospital and the Pediatric Brain Tumor Consortium (PBTC) revealed findings of a pediatric brain tumor study using an experimental drug that targets the underlying genetic makeup of the tumor.
LYNNE JETER |
HEALTHCARE LEADER: Rusty DeGeorge
CEO, Conrad Pearson Clinic
Don't let Rusty DeGeorge's soft voice and laid back southern charm mislead you; he has seen both global suffering and daunting domestic challenges, and he is passionate about addressing them and making a difference in today's world.
JUDY OTTO |
New Immunization Rules Impact School, Day Care Enrollment
It's been a decade since Tennessee last updated immunization requirements for children. An enhanced schedule, which became official at the end of 2009, impacts those enrolling in day care, pre-school, elementary/middle school and college.
CINDY SANDERS |
Children Are Not Small Adults
Nanopediatrics Emerges to Ensure Nanotechnology Encompasses Kids
Imagine a pump the size of a molecule delivering medicine directly in the body where it's needed. Or a miniscule tool programmed to seek out and destroy the first cancer cells of a tumor. That's the promise of nanomedicine, medical applications in the much broader field of nanotechnology. Yet, as such customized medical innovations are being researched, Edward R.B. McCabe III, MD, has one reminder: Kids are different.
SHARON H. FITZGERALD |
Long Wait Over
Methodist Wins CON Approval to Build Hospital in Olive Branch
After years of wrangling, Methodist Le Bonheur Healthcare has been given the green light to build a new 100-bed acute care hospital in Olive Branch.
LYNNE JETER |
Sometimes I Wish Something Could Just Stay the Same
Version 5010 Transition for Electronic Claims Submission
With almost 100 percent of Medicare Part A claim transactions being submitted electronically (and just over 96 percent of the Part B claims) using the Version 4010/4010A1 of healthcare standards, payers and providers must implement, test and transition to the 5010 Version transaction to be compliant with HIPAA no later than January 1, 2012.
BETTY HATTEN |
8 NEW LAWS PHYSICIANS SHOULD KNOW ABOUT
In the last 4 months, there have occurred a number of important changes and developments in both state and federal healthcare laws. This article will highlight 8 of these laws that have the potential immediately to impact physicians and their practices.
Angela Youngberg |
Maximizing Reimbursements
In an environment of rising costs and diminishing returns, it's easy to hone in on contracted rates as the sole source of financial woes. Certainly, negotiating favorable reimbursements with payers is key to a healthy bottom line, but it's really only half the story.
CINDY SANDERS |
Medical Economics: Managed Care Contracting - Helpful Hints
Do your homework. Before proceeding in negotiations with a payer, make sure you have an understanding of the extent of leverage you have with the plan. This will drive the negotiation process. If you have negotiated a contract before, you most likely will know the payer representative you will be working with. If not, ask questions of you colleagues about the payer and the payer representatives that have responsibility in your market.
BILL APPLING |
PHYSICIAN SPOTLIGHT: Bruce Maley, MD
Talk to Jackson pediatrician Bruce Maley, MD, for just a minute and it is easy to see why he takes care of kids. The unabashedly proud family man knew in medical school he wanted either to bring children into the world or take care of them once they arrived. If he had only enjoyed surgery more, he may have gone with obstetrics and gynecology. Fortunately, for the kids in West Tennessee, he followed his heart into pediatrics.
SUZANNE BOYD |
Healthy Memphis Commontable Update
Healthy Memphis Common Table (HMCT), the regional health and healthcare improvement collaborative for the greater Memphis area is pleased to announce our 2010 Board of Directors
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The Race of a Lifetime
Prostate cancer has been winning the race for some time now. This year alone 28,000 men will die from this debilitating disease, but it doesn't have to keep winning. This year on Saturday, September 11, Memphis is hosting the Great Prostate Cancer Challenge. This national event is our chance to fight back against this silent killer; it is our chance to beat prostate cancer and win the race of life.
NATHAN RIDENOUR |
RESEARCH REPORT: Porterfields Lead Groundbreaking Study on ICD Reliability
After leading a groundbreaking study on the long-term reliability of an implantable cardioverter defibrillator (ICD), James G. Porterfield, MD, and his wife, Linda M. Porterfield, PhD, from Methodist University Hospital, determined that St. Jude Medical Riata defibrillation lead adverse events are low and fall within the range of currently recognized standards.
LYNNE JETER |
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