The prior authorization process is a frequent, time-consuming process for physicians. A survey of 1,000 physicians revealed they made prior authorization requests 37 times per week on average, according to data from the American Medical Association. About one-fifth of the survey participants said it takes 20 hours to do these requests each week. It’s no wonder small and large health IT vendors see opportunities to use technology to create a more efficient workflow. It’s also yet another reason One of the best and most recent examples of the opportunity health IT vendors see in this market is the huge acquisition of CoverMyMeds earlier this year. (more…)
Sepsis was the most common inpatient discharge in 2015, costing Medicare more than any other condition or procedure for the first time since the CMS started to release the payment information to the public four years ago. Joint replacements have historically beat out sepsis and the 98 other inpatient stays the CMS includes in its data set as the most common—and costly—inpatient discharge. But the release this week of 2015 Medicare claims data paints a new picture: payments for joint replacements are on the decline, while sepsis payments are on the upswing.
Buy, sell, hold course. Whatever the decision, there won’t be any quick fixes for whoever takes over for ousted Tenet Healthcare Corp. CEO Trevor Fetter.The for-profit healthcare company carries $15 billion of debt making it prohibitively expensive to be bought outright. And its three main divisions—hospitals, United Surgical Partners International and Conifer Health Solutions—are unlikely to bring enough money at sale to sufficiently reduce debt or, in the case of the hospital business, has no buyer desiring to buy it whole, said Mizuho Securities analyst Sheryl Skolnick.
Driven in part by strong patient volumes, Cleveland Clinic’s operating income for the first half of this year was more than four times the like timeframe in 2016, according to a new bond disclosure document.Through June 30, the system’s operating income was $191.2 million, resulting in a 4.5% operating margin, according to the system’s Interim Unaudited Consolidated Financial Statements. In the first half of last year, the system reported operating income of $47.6 million and an operating margin of 1.2%, which the clinic last year attributed to small reimbursement and rising operating costs.