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Commercial insurance margins offset rising Medicare losses

Commercial insurance margins offset rising Medicare losses

By Dave Barkholz  |  May 07, 2016

As hospital margins on traditional fee-for-service Medicare patients plunged deeper into the red, cost-cutting at hospitals has allowed many to make up those losses from their commercially insured clientele.

MedPAC outlines post-acute pay overhaul, backs Part D changes

By Virgil Dickson  |  April 07, 2016

The Medicare Payment Advisory Commission has completed work on a road map for overhauling how the program pays for post-acute care. The advisory panel voted to back a variety of changes to the Part D prescription drug program that could save as much as $10 billion over five years.

Change agents charge to the top

Change agents charge to the top

By David May  |  April 02, 2016

As conversations in healthcare continue to focus on quality, patient safety and a system shifting to value over volume, Modern Healthcare's 12th annual ranking of the 50 Most Influential Physician Executives and Leaders increasingly reflects the industry players charged with making it happen.

Does CMS' Part B drug reimbursement proposal usurp clinical judgment?

By Virgil Dickson  |  March 12, 2016

Medicare's plans to overhaul the way it reimburses doctors and hospitals for the more than $20 billion worth of outpatient drugs they administer each year has sharply divided the provider community. The fault lines roughly align with the stakes in the status quo.

Final unified post-acute care pay system is coming

By Virgil Dickson  |  March 03, 2016

MedPAC is wrapping up work on a report that outlines a unified payment system for post-acute care settings. The panel will vote on a formal report next month. It also plans to suggest the CMS accelerate its timeline of when the new pay scheme will see the light of day.

Controversial home visits duck Medicare's radar, for now

By Bob Herman  |  February 27, 2016

The most interesting thing about the preliminary rate notice for 2017 Medicare Advantage plans may be what federal policymakers left out. The thick document made no mention of health-risk assessments, which surprised the industry.

MedPAC backs slashing drug payments to 340B hospitals

MedPAC backs slashing drug payments to 340B hospitals

By Virgil Dickson  |  January 16, 2016

The Medicare Payment Advisory Commission has backed a proposal to reduce Part B drug payment rates for hospitals participating in the 340B Drug Pricing Program, though members had signaled they would oppose it.

Site-neutral Medicare payments on Congress' agenda

Site-neutral Medicare payments on Congress' agenda

By Shannon Muchmore  |  January 02, 2016

Congress is likely to take up a measure in the new year that would exempt hospital outpatient departments currently under construction from a “site-neutral” Medicare payment provision, which made it into the two-year budget deal in October that avoided a potential default on the...

MedPAC starts work on model to alter post-acute care pay

By Virgil Dickson  |  September 10, 2015

The Medicare Payment Advisory Commission is starting the complex work of balancing quality of patient care with building a prototype that may change how Medicare reimburses skilled-nursing facilities, home health agencies, inpatient rehabilitation facilities and long-term-care hospitals.

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