StuWilli, Author at Journal of Urgent Care Medicine

ACA: A Bust for Insurers, a Boon for Big Hospital Systems

Where the Affordable Care Act (ACA, or “Obamacare”) is proving to be a major financial challenge for insurers, some large hospital systems are experiencing a windfall since it launched. Tenet and HCA Holdings each say that ACA member admissions were up significantly over the previous fiscal year’s results. Tenet reports a 28% increase in inpatient admissions for that segment, with overall patient revenue going up 6%; HCA’s ACA inpatient hospitalizations were up 27%. The companies have …

Update: Humana’s Four-State Exodus Leaves Alabama in a Tough Spot

Last week we told you about Humana’s plans to drop out of Affordable Care Act (ACA, or “Obamacare”) insurance exchanges in certain states. Now the company has revealed that one of those states is Alabama—leaving just one ACA exchange in the entire state, effective Dec. 31, 2016. The other states (so far) are Kansas, Wisconsin, and Virginia, though news regarding more states may still be ahead. The company first said it would consider exiting certain …

Collecting Your Own Patient Experience Data May Be More Help than Yelp

Probably more than for any other setting, patients rely on information they find online before deciding to visit an urgent care clinic. If you have stellar reviews on Yelp or other online review platforms, you’re in good shape, but the randomness of such sources can be a problem. Sentara Healthcare took matters into its own hands by surveying its own urgent care patients, resulting in 10,000 responses, and posting their results online. Working with National …

Is America’s Uninsured Problem Being Replaced by America’s Underinsured Problem?

URGENT MESSAGE: Although the Affordable Care Act has made some progress in reducing the number of Americans without any health insurance, many of the newly insured are still unable to afford routine healthcare due to plan designs that include high deductibles, copays and coinsurance. Alan A. Ayers, MBA, MAcc is Practice Management Editor of JUCM—The Journal of Urgent Care Medicine, a former member of the Board of Directors of the Urgent Care Association of America, …

Ohio Law Gives PAs More Clinical Authority with Less Physician Oversight

Physician assistants in Ohio now have more authority to make decisions—including more freedom to prescribe drugs—under a new law signed into effect by Gov. John Kasich. While PAs still must work under the supervision of a physician, they have more autonomy when it comes to ordering diagnostics, prescribing or directly providing medications, and administering local anesthesia. While urgent care centers typically have physicians on site most or all of the time, retail clinics like those …

FDA Panel Calls for Mandatory Opioid Training

Physicians who prescribe opioid pain medications would have to undergo a higher level of specific training under a guidance recommended by a Food and Drug Administration advisory panel. In response to a perceived epidemic of opioid addiction and related deaths, the panel voted unanimously to advice requiring more education about the drugs’ risks. The panel’s vote was unanimous, but not binding—though the FDA does often follow recommendations made by its outside expert panels.

Humana Follows United Out the ACA Exit Door

In advance of formal approval of its merger with Aetna, Humana plans to stop participating in some state insurance exchanges constructed under the Affordable Care Act (ACA, or “Obamacare”). The company says its member base dropped 21% compared with the first quarter of 2015. That includes those who bought policies under the ACA exchanges, which many insurers say are hard on their bottom lines to begin with. UnitedHealth Group was the first major insurer to …

IMS Health–Quintiles Merger Weds Research and Information Technologies

IMS Health Holdings Inc. and Quintiles Transnational Holdings are merging in an all-stock deal aimed at creating “a leading portfolio of anonymous patient records, technology-enabled data collection, and observational research experts to address critical healthcare issues of cost, value, and patient outcomes.” The new company, to be called Quintiles IMS Holdings, says its combined strength will be to support drug development from inception through demonstrating the value of new medicines. The 2015 combined revenue of …

Will New CMS Program Boost Medicare Quality Bonuses?

The Centers for Medicare and Medicaid Services (CMS) calls it a brand-new platform, while skeptics are saying it’s just the same-old structure with a fresh coat of paint. Either way, CMS is rolling out the Quality Payment Program, which it says will ease documentation requirements for physicians while also providing new opportunities to earn bonuses by providing quality care. Under the program, physicians can receive Medicare reimbursement by participating in either the Merit-Based Incentive Payment …

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