private insurers

The profit gap between Milwaukee and its surrounding suburbs is growing, due in part to low Medicaid and Medicare reimbursement rates. While Milwaukee's suburban hospitals enjoy profit margins that exceed the national average, some urban hospitals are barely breaking even. As with other markets across the country, a disproportional number of Milwaukee patients with Medicare or Medicaid are cared for by urban hospitals--and it's hard to make that work financially.

This trend isn't …

Last week the Los Angeles Times reported that as many as one in five organ transplant programs don't meet federal certification standards. On Tuesday, CMS head Mark McClellan defended the program in a letter to Senator Charles Grassley (R-IA), who had demanded an explanation of the Times article's finding. McClellan stated that the federal government increased oversight last fall in response to problems with the University of California Irvine transplant program. …

The non-profit Markle Foundation released a report today that assesses the impact e-prescribing had during the response to Hurricane Katrina. In the days after the storm struck, a group of non-profits and tech companies pooled their resources to launch KatrinaHealth.org, a Web site that gave authorized medical professionals online access to medical information gathered from a number of sources. Organizers were able to gain access to prescription data from government databases, private …

The mechanics of healthcare reimbursement have been getting more inches than you might expect in The New York Times recently. We've heard in the last few days about the length of time it takes insurers to pay providers (too long), the rate of electronic claims submission (getting higher) and how much Medicare pays hospitals compared to private insurers (not enough). Is it …

Under new legislation floated in Minnesota, medical device manufacturers could wind up paying the entire bill for a patient's treatment and rehabilitation when a pacemaker or defibrillator is recalled. Congressman Tony Cornish (R) introduced the legislation Monday, saying it is unfair for either Medicare or private insurers to have to pay for a device maker's mistakes. Leading device companies Medtronic, Guidant and Boston Scientific all have production facilities in the state. Device …

A new survey released by industry trade group America's Health Insurance Plans (AHIP) challenges the view that Medicare Part D is a disaster. The study, which was conducted by Alexandria, VA-based Ayres, McHenry & Associates found that 8 out of 10 seniors who enrolled in a Part D plan had no trouble doing so. Three out of five surveyed said they had saved money. "What seniors are saying is this program is working for them. It's making a difference," said AHIP President Karen …

The Washington Post reports that House Chairman Jon C. Porter (R-NV) plans to introduce legislation that would encourage the use of electronic medical records (EMRs) in the Federal Employees Health Benefits Program. The government program provides health insurance to approximately 8 million federal employees. Porter says providing EMRs to federal employees would encourage private insurers to adopt the technology. The bill would allow private insurers to collect some federal money …

Though subsidized by the federal government, private insurers are responsible for delivering Part D to Medicare recipients. Federal officials are now warning against aggressive tactics being used by some of these insurers and salespeople to market the new Medicare prescription drug benefit. According to CMS, some companies are going door to door to market plans. Others are asking for "inappropriate" information such as social security numbers and bank account information. A CMS spokesman …