The Agency for Healthcare Research and Quality has issued its 2018 National Healthcare Quality and Disparities Report. The Report
assesses the performance of our healthcare system and identifies areas of strengths and weaknesses, as well as disparities, for access to healthcare and quality of healthcare. Quality is described in terms of six priorities: patient safety, person-centered care, care coordination, effective treatment, healthy living, and care affordability. The report is based on more than 250 measures of quality and disparities covering a broad array of healthcare services and settings.Check it out.
The Kaiser Family Foundation has issued an analysis of 2019 medical loss ratio refunds under the Affordable Care Act that health insurers are obligated to pay.
Using data reported by insurers to CMS, we estimate insurers will be issuing a total of at least $1.3 billion across all markets – exceeding the previous record high of $1.1 billion in 2012 (based on 2011 experience). The amount varies by market, with insurers reporting at least $743 million in the individual market, $250 million in the small group market, and $284 million in the large group market.The insurers tend to get tripped up on the state by state approach that the ACA uses.
Mhealth Intelligence reports that the American Medical Association ("AMA") which controls the medical procedure code set used in claim transactions has added several important new codes to the 2020 CPT 4.
Among the 248 new codes added to the list for the coming year, the AMA has created six for online digital evaluation services, or e-visits, in which care providers can connect with patients at home to exchange information. Three codes – 99421, 99422 and 99423 – relate to patient-initiated digital communication provided by a physician or other qualified healthcare professional, while three others – 98970, 98971 and 98972 – focus on communications with a “non-physician healthcare professional.”