Medicaid

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Puerto Rico’s Health-Care Crisis Threatens the Mainland

Mattie Quinn | Governing | March 1, 2016

Just a few years ago, New York had a health-care crisis on its hands. The state was spending $50 billion a year on Medicaid in 2011 -- more than any other state in the country. Health-care officials in New York worked together to bring down spending, and last year the state introduced an $8 billion plan to repurpose its whole program, with a focus on outpatient care and community health. But now the state is facing another threat to its health-care system: Puerto Rico. America’s biggest territory continues to find itself in serious financial trouble, with a current debt of $72 billion, which the territory’s governor has declared "not payable"...

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Q&A: Mostashari on the Innovations Electronic Data Will Spark

Mary Mosquera and Tom Sullivan | Government Health IT | June 17, 2011

Electronic health records are only a beginning of sorts. Although a top priority for providers, the meaningful use of EHRs is not the end goal – rather, the health data that EHRs make more accessible stands to unleash a wave of applications, products and services that ultimately catalyze improvements in health care, delivery and outcomes for both individual and population health. Read More »

Quit the RUC

Brian Klepper and David Kibbe | Kaiser Health News | January 20, 2011

Three times a year, 29 doctors gather around a table in a hotel meeting room. Their job is an unusual one: divvying up billions of Medicare dollars.

The group, convened by the American Medical Association, has no official government standing. Members are mostly selected by medical-specialty trade groups. Anyone who attends its meetings must sign a confidentiality agreement. Read More »

Rep. Burgess' Office Releases Draft Interoperability Bill for Discussion

The office of Rep. Michael Burgess, MD (R-TX) released a draft of the interoperability bill that they have been working for the past several months on Friday. Rep. Burgess, one of the few physicians in Congress, has been working very hard with his staff to come up with legislation that can fix the current Health IT "lock-in" crisis. This is a bipartisan effort that has full backing from the top leadership in Congress. The staff is seeking input from the Health IT community on the draft bill. Burgess's office will take comments on the draft through March 13. Rep. Burgess' staff was kind enough to provide Open Health News with a copy of the draft legislation. We have posted the entire draft bill as is below and will be writing some our thoughts over the next few days. 

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Report Outlines IT Challenges And Guidelines For State HIXs

Anthony Brino | Government Health IT | September 20, 2012

Along with the financial challenges of creating health insurance exchanges, and some of the political resistence to them, state governments have an enormous amount of IT work to do — perhaps chief among all the tasks is replacing arcane software with IT that can link HIX, Medicaid and CHIP systems, and function like Amazon.com. Read More »

Report: EHR Market to Grow at Steady Pace, Reach $8.3B by 2016

Jeff Byers | CMIO | November 10, 2011

The U.S. market for electronic health record systems is expected to reach $8.3 billion by 2016, growing at an annual rate of more than 12%, according to a report from Millennium Research Group, a Toronto-based market research firm, Health Data Management reports. Read More »

Researchers to Examine Revamp of Public Health

Christina Jewett | California Watch | February 15, 2012

As California continues to forge ahead implementing health reform, state Medi-Cal leaders and UC Davis researchers announced an agreement to examine public health system transformation efforts that may serve as models for the nation. The researchers will evaluate public hospital systems as they revamp daily operations in ways meant to simultaneously reduce health costs and improve patient Read More »

Results Of State Legislatures, Ballot Initiatives Could Spark Conflict With Feds

Anthony Brino | Government Health IT | November 7, 2012

American voters considered 174 ballot measures in 38 states Tuesday and shifted the balance of power in several state capitals, in some places potentially setting up a battle between state and federal law. Read More »

RowdMap, Inc. Speaks at Health:Further Summit on Creating High-Value Care from Open Health Data

Press Release | RowdMap, Inc. | August 16, 2016

Joshua Rosenthal, PhD, Chief Scientific Officer and Co-Founder at RowdMap, Inc., will be speaking on how health plans and physicians and hospitals create high-value care with open data from the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS). According to the Institute of Medicine (IOM), thirty cents of every dollar goes to low-value care, or care that has higher risks and costs but does not produce better outcomes. According to researchers, if low-value care were removed, there would be more than enough care to cover the population...

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Samuel Shem Calls for Using VistA and the VA Model of Care to Solve the Physician Burnout Crisis

On November 1st Newsweek published an extraordinary Op-Ed by Samuel Shem titled Why Computerized Medical Records Are Bad for Both You and Your Doctor. In the article, Shem, pen name for the American psychiatrist and well-known author Stephen Joseph Bergman, presents evidence that poorly designed electronic medical records (EMRs) and over-regulation are to blame for the growing crisis of physician burnout and suicide. The rate of suicides among physicians has risen to a staggering number--three per day. Shem argues that there is a "better way," and that is shown by the electronic health record (EHR) system used by the U.S. Department of Veterans Affairs (VA). The VA's EHR is called VistA. Shem's view is supported by a large and increasing number of physicians and nurses. Read More »

Sending Medicaid to the Cloud

David Raths | government technology | January 12, 2016

Led by Wyoming, states are ready to pioneer MMIS as a service. The Wyoming state government already has considerable experience with cloud-based services. It uses Google Apps for Government, NEOGOV for human resources and is looking at Salesforce.com for customer relationship management. But as its Department of Health prepares to issue an RFP to replace its Medicaid Management Information System (MMIS), all eyes in the Medicaid IT sector are on Wyoming because it will be the first time a state has tried to move away from an expensive custom-developed system to an MMIS-as-a-service approach.

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Short-Sighted Conservative Gloating On Obamacare

Ed Kilgore | Washington Monthly | October 23, 2013

Truth be told, some of the more interesting writing on the travails of the Obamacare enrollment system is coming from conservative Ross Douthat of the New York Times. On Sunday, he warned Republicans that their cackling over the enrollment mess was obscuring the realization that the Medicaid single-payer element of the Affordable Care Act was functioning better than the private insurance part of the insurance expansion... Read More »

Soaring Generic Drug Prices Draw Senate Scrutiny

Matthew Perrone | ABC News | November 20, 2014

Some low-cost generic drugs that have helped restrain health care costs for decades are seeing unexpected price spikes of up to 8,000 percent, prompting a backlash from patients, pharmacists and now Washington lawmakers...

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SOS: Puerto Rico Is Losing Doctors, Leaving Patients Stranded

Greg Allen | NPR | March 12, 2016

Puerto Rico is losing people. Due to a decade-long recession, more than 50,000 residents leave the U.S. territory each year—most for jobs and new lives on the mainland. This issue is especially affecting healthcare, where it's estimated that at least one doctor leaves Puerto Rico every day. The mass exodus of doctors is creating vacancies that are hard to fill and waiting lists for patient care. Dr. Antonio Peraza is among those doctors who recently left for the mainland. He specializes in internal medicine and for nearly 14 years, had a private practice in Bayamon, Puerto Rico...

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States' Medicaid Expansion Fraught With Political Consequences

Mary Mosquera | Government Health IT | September 20, 2012

States are facing complex choices about whether to expand Medicaid coverage since it’s their call now and they will not be forced to do so under the health reform law. Read More »