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Text Version   RSS   Subscribe   Unsubscribe   Archive   Media Kit September 10, 2015

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INDUSTRY NEWS

Narrow insurance networks — popular in NJ — extend to relatively few providers
NJ Spotlight
New Jersey was among the states with the largest share of health insurance plans that offered relatively little choice of doctors to individual consumers, according to a new research brief. Two of three New Jersey insurance networks that were studied included fewer than 25 percent of the doctors in the state, according to researchers with the University of Pennsylvania. Networks that extend to relatively few doctors are known as "narrow networks."
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More precise medical codes aim to track quality of care
New Jersey Herald
If things are a bit tense in your doctor's office come Oct. 1, some behind-the-scenes red tape could be to blame. That's the day when the nation's physicians and hospitals must start using a massive new coding system to describe your visit on insurance claims so they get paid.
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Hospital merger-mania continues in NJ
NJ.com
When it comes to hospitals, New Jersey executives believe bigger is better. Since January 2014, there have been eight mergers and acquisitions proposed, although most are still waiting for approval. The Attorney General and the state Health Department must deem them beneficial for the communities they serve before they are allowed to proceed.
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More precise medical codes aim to track quality of care
The Associated Press via New Jersey Herald
If things are a bit tense in your doctor's office come Oct. 1, some behind-the-scenes red tape could be to blame. That's the day when the nation's physicians and hospitals must start using a massive new coding system to describe your visit on insurance claims so they get paid. Today, U.S. health providers use a system of roughly 14,000 codes to designate a diagnosis, for reimbursement purposes and in medical databases. To get more precise, the updated system has about 68,000 codes, essentially an expanded dictionary to capture more of the details from a patient's chart.
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New Jersey docs are last in EHR use
MD Magazine
New Jersey's office-based physicians have been the slowest in the nation to switch to electronic health records, according to a new report from the Centers for Disease Control and Prevention. Electronic health records are a key component in national efforts to make healthcare more efficient — and to keep tabs on what procedures and therapies physicians are using in treating patients. They also generate the big data beloved by health experts, the pharma industry and insurers.
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CVS Health expands its telehealth services for customers
By Scott E. Rupp
CVS Health recently announced that it will work with three "leading" telehealth companies to expand patients' access to doctors, who will be able to provide consultations remotely via the Internet or on the phone. As part of the deal, the three companies — American Well, Teladoc and Doctor On Demand — will soon begin receiving customers from CVS pharmacies in six states, and they will refer their own customers to 150 CVS walk-in clinics.
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NJ's approach to Medicaid ACOs is an experiment worth watching
Health Affairs
As the July issue of Health Affairs recognized, Medicaid has become a hotbed for healthcare transformation, with states increasingly turning to Accountable Care Organizations (ACOs) and medical homes to reduce costs and improve care delivery in their Medicaid programs. New Jersey joined the ranks in July by certifying three of six applicants for the New Jersey Medicaid Accountable Care Organization Demonstration Project — the Camden Coalition of Healthcare Providers, the Healthy Greater Newark ACO and the Trenton Health Team.
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NJ hospitals that can do a better job of safeguarding patients
NJ Spotlight
Washing hands. Giving patients the right medication. Having enough qualified nurses. Those are among the basic steps that hospitals and their workers can take to ensure that patients are as safe as possible. They're also areas in which some New Jersey hospitals have room to improve, according to conclusions drawn from data collected by the Leapfrog Group, a nonprofit dedicated to improving healthcare quality. The organization scored hospitals in eight areas it described as "steps to avoid harm." Those scores were then combined into an overall rating of 1 (the lowest) to 4 (the highest).
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Report: NJ owes $32 million for improperly billing Medicaid for home healthcare
NJ.com
The state improperly billed $32.2 million for home health services it could not document over a 3-1/2-year-period and should return the money to the federal government, according to a U.S. Office of Inspector General report. A random audit of 100 claims submitted from 2008 to 2011 found 17 to be in error because they did not contain proper documentation, according to the report. The deficiencies included nurses not making required visits, companies using untrained home health aides, and failing to maintain patient files.
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ACO incentives not enough to inspire change in compensation policies
Healio
Primary care physicians that worked in accountable care organization practices received higher compensation rates from quality, but not from salary or productivity, where rates were comparable with non-accountable care organization practices, according to recently published data.
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