AAOS Now, June 2016
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Health Insurance Mergers May Fundamentally Change Market
Recently proposed mergers between the healthcare giants Anthem/Cigna and Aetna/Humana would reduce the number of national health insurance providers from five to just three, spurring questions about the potential effects of reduced competition. In response, a great deal of attention has focused on whether the U.S.
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More about PQRS 2016: What You Need to Know
As we move through the final year of the Physician Quality Reporting System (PQRS) in 2016, some physicians may be looking forward to saying goodbye to this program forever. Those sentiments may be a bit premature. Although the PQRS program in its current form will be ending, PQRS will continue as part of the Merit-Based Incentive Payment System (MIPS). (See cover story, "CMS Releases MACRA Proposed Rule).
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Optimizing Patient Safety while Transferring Information
Patient safety relies, to a significant extent, on healthcare providers' ability to exchange critical information about patients effectively and to properly manage handoffs from one provider to another. Fortunately, a few simple rules for exchanging important patient information have been shown to dramatically increase the likelihood of success.
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CMS Releases MACRA Proposed Rule
On April 27, 2016, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule detailing, for the first time, the physician reimbursement framework required by the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. MACRA, which replaced the flawed Sustainable Growth Rate (SGR) formula, created a new program for physician reimbursement that streamlines quality programs and addresses reporting burdens.
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The Death and Rebirth of Gainsharing: Payment Opportunities for the Orthopaedic Surgeon
"Gainsharing" is a popular management and incentive compensation strategy that is often used in manufacturing and by companies with industrial service lines. It is used to reduce costs by paying incentives to employees who develop or participate in cost-saving strategies. The amount of the "gainshare" incentive payment is typically based on the amount of cost savings produced by the employee, as determined by a preset formula and other performance measures.