By Virgil Dickson for Modern Healthcare Health plans and state Medicaid directors disagree on how the CMS should fix its problem of underpaying plans with high numbers of dually eligible Medicare and Medicaid beneficiaries. In October, the CMS announced it would modify its risk-adjustment model after an analysis of reimbursement data revealed that some health plans… Continue reading Payers, States at Odds on CMS Plan to Fix Dual-Eligible Underpayment

Is It Pressure? See this video of our recent “Identifying Pressure Ulcers: Assessment and Staging” webinar, including a wound identification cheat sheet!

By Rob Smith for Puget Sound Business Journal The Washington Health Alliance has been tapped to participate in a national effort to reduce the cost of health care. The Seattle-based nonprofit organization, which consists of 175 health-care groups across the state, works to bring price transparency to health care, with the goal of reducing costs.… Continue reading Washington Health Alliance Joins National Effort to Reduce Price Confusion

Originally Published by The Lawndale News Building on Chicago’s ongoing efforts to ensure that its residents have access to affordable healthcare coverage, Mayor Rahm Emanuel announced at an event with Senior Advisor to the President Valerie Jarrett that Chicago will participate in the White House’s Healthy Communities Challenge—a national initiative designed to assist uninsured citizens… Continue reading Chicago Joins White House’s Healthy Communities Challenge

Published on California Healthline Facilities across California that offer services to individuals with developmental disabilities temporarily closed Wednesday in the wake of a mass shooting at Inland Regional Center in San Bernardino, the Sacramento Bee‘s “Capitol Alert” reports. Background on Centers Inland Regional Center is the largest of 21 such facilities that operate under a… Continue reading Calif. Developmental Disabilities Centers React to Shooting

By Zachary Tracer and Matthew Winkler for Bloomberg Business To reduce turbulence in Obamacare’s fledgling insurance markets, the Obama administration’s top health official is pushing to get more information to consumers about what they’ll actually pay for health care, which can include out-of-pocket costs as well as premiums. The changes are meant to help people choose coverage that fits… Continue reading Top Obamacare Official Makes Tweaks as Insurer Complaints Grow

by George Lauer, California Healthline Features Editor The moral of the story about a disagreement over what Blue Shield of California is expected to do in return for approval to enter the Medi-Cal managed care market appears to be “pay close attention to how things are worded.” Consumer advocates and state officials thought the agreement this… Continue reading Disagreement Over Charity Contributions Simmers in Blue Shield’s Care1st Deal

In this article originally published by The New York Times, read why some are saying sky-high deductibles that are leaving some newly insured vulnerable.

Nancy Morgan of the Wound Care Education Institute takes viewers of this recorded webinar into the world of identifying pressure injuries.

Originally published by Modern Healthcare - The CMS is working to develop a separate star-rating system for health plans participating in an experiment.