Thursday, April 12, 2012

Mid-week update

Modern Healthcare reports "measured enthusiasm" from healthcare providers on the proposed one year long long ICD-10 delay. The AHIMA trade association of techies thinks that it could have been worse. And it could have been worse -- HHS could have given a longer delay just to doctors. AHIMA thinks that a longer delay would have encouraged doctors to suspend work on the project.

A federal district court judge heard three hours of oral arguments on Tuesday about the drug store trade association's motion to keep separate the respective assets of Express Scripts and Medco while their anti-trust action is pending. According to Drug Store News, the judge indicated that she will rule on the preliminary injunction motion and the defendant's motion to dismiss later. What the FEHBlog finds interesting is that there has been no rush to the courthouse by any State Attorney General to challenge the merger. The fat lady may be warming up.

In other bit of anti-trust news, the U.S. Justice Department's Anti-trust Division announced Tuesday that it was closing its investigation into Highmark's affiliation agreement with the six hospital West Penn Allegheny Health System. In November 2011, Highmark announced a $475 million capital infusion into the financially ailing system which has sparked a controversy between Highmark and the competing hospital chain UPMC. The Pittsburgh Post Gazette surveys the reaction here.

Finally CMS announced that 27 accountable care organizations in 18 states have been admitted to the Medicare Shared Savings Program. Modern Healthcare reports that
The first ACOs will include more than 10,000 physicians, 10 hospitals, and 13 smaller physician-led entities and serve an estimated 375,000 beneficiaries. The announcement follows the January launch of the modified Pioneer Model ACOs with 32 healthcare groups. The mix of organization types—just over half are physician-led—was touted by CMS officials.
Of course, the AMA was ecstatic but be careful what you wish for because a lot of physician risk bearing health care organization went under in the 1990s due to bad risk management.

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