Machine learning identifies preop risks linked to postop Medicare super-users
Editor's Note In this study of more than 1 million Medicare patients, 4.8% were super-users of healthcare and incurred 31.7% of Medicare expenditures after surgery. A machine learning approach identified the following as the most significant risk factors linked to super-utilization of healthcare in the year following surgery: hemiplegia/paraplegia weight…
Family healthcare costs outpacing wages, inflation
Editor's Note Enrollees in large employer insurance plans are facing higher healthcare spending through rising premium contributions and increased cost-sharing, according to an August 14 report from the Kaiser Family Foundation. Healthcare costs outpaced wage growth from 2008 to 2018, with employees spending $4,706 for premiums and $3,020 on out-of-pocket…
CMS proposes giving Medicare patients better access to cutting-edge devices
Editor's Note In its proposed rule, the Centers for Medicare & Medicaid Services (CMS) would give Medicare patients better access to innovative devices beginning next year, the July 30 MassDevice reports. CMS also says it might pay more for “certain transformative new devices” for inpatients, using a new technology add-on…
AI helps Aetna resolve claims overnight
Editor's Note Health insurer Aetna has created an artificial intelligence (AI) software to settle insurance claims−a development that could lead to automation of other processes and free up staff to focus on higher-level tasks, the July 25 CIO reports. Aetna estimates the software, which is able to resolve claims overnight…
House to vote on repeal of ACA’s tax on high-cost insurance plans
Editor's Note House Leaders will vote the week of July 15 on a measure to repeal the Affordable Care Act’s 40% tax on high-cost healthcare insurance plans, the July 12 Bloomberg Tax reports. The measure is expected to have wide bipartisan support. Democrat Rep Joe Courtney of Connecticut is the…
CMS finalizes coverage policy for TAVR
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on June 21 issued final updates to its national coverage policy for Transcatheter Aortic Valve Replacement (TAVR). The update provides more flexibility in how centers meet volume requirements for performing TAVR, while emphasizing the importance of the heart team for…
CDC: No significant change in 2018 uninsured rate
Editor's Note The Centers for Disease Control and Prevention (CDC) on May 9 released a National Health Interview Survey that found an estimated 9.4% of US residents (30.4 million people) lacked health insurance in 2018, which is not significantly different than in 2017, but it is 18.2 million fewer than…
Effect of ACA on ED visits, hospital discharges
Editor's Note Though emergency department (ED) visits and hospital discharges by uninsured patients decreased after implementation of the Affordable Care Act, 1 in 10 ED visits and 1 in 20 hospital discharges were still made by uninsured patients from 2014 to 2016, this study finds. There were 1.4 million…
Haven is new name for Amazon-backed healthcare venture
Editor's Note The healthcare organization founded by Amazon, Berkshire Hathaway, and JP Morgan Chase announced on March 6 its new name−Haven−along with the launching of its new website www.havenhealthcare.com. The website outlines some of the areas where Haven intends to make improvements on the current healthcare system, including access of…
Researchers pinpoint factor that predicts unplanned readmissions
Editor's Note The widely used “LACE index,” which assesses a patient’s risk of hospital readmission, has a “blindspot” because it fails to consider whether patients are on Medicaid, West Virginia University researchers say. LACE stands for length of stay, acuity, comorbidity, and emergency department. To assess the predictive value of…
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- Catheter sterility concerns prompt Class 1 FDA recall for surgery trays
- Large amounts of personal data possibly stolen in Change Healthcare cyberattack
- AI model helps predict patient decline, drive collaborative care
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