With more quality and pricing data available now than ever before, insurers and employers are trying to figure out how to steer patients toward high-performing, low-cost doctors. Companies such as the Leapfrog Group and nonprofits like FAIR Health are creating tools that make medical data easier to access, but turning patients into rational consumers is […]
Q-1. What is the definition of “small group” as of January 1, 2016? A. Under New York law and the Patient Protection and Affordable Care Act (ACA), the definition of “small group” will be 1-100 employees as of January 1, 2016. See Q-6 thru Q-11 below for who is an employee. Q-2. Will New York […]
For all their talk about evidence-based medicine, a lot of doctors don’t follow the clinical guidelines set by leading medical groups. Consider, for example, the case of cataract surgery. It’s a fairly straightforward medical procedure: Doctors replace an eye’s cloudy lens with a clear, prosthetic one. More than a million people each year in the […]
In a “historic” announcement, the Department of Health and Human Services on Monday set new goals for tying Medicare payments to quality or value through alternative payment models. The news received widespread print and online media coverage and is portrayed as an ambitious step by the Administration. Most sources also report on the generally positive […]
When the 48-year-old man from Oregon didn’t have insurance, he felt he had no place to go but the emergency room. The man, who has diabetes, went to the emergency room often when he suffered from kidney stones. “Emergency rooms, from what I understand, they can never turn you away,” he said. “I mean, you […]
Consumers searching this fall for the best doctor covered by their new public or private insurance plan won’t get very far on a federal database designed to rate physician quality. The Affordable Care Act requires the Centers for Medicare and Medicaid Services to provide physician quality data, but that database offers only the most basic […]