Medicare's payment reform push draws praise and fears

By Melanie Evans and Paul Demko  |  January 26, 2015

By 2018, half of Medicare spending outside of managed care will be tied to incentives to manage quality and costs, federal officials said Monday. That was greeted with enthusiasm but also with warnings that the effort will be wasted if the new models are too weak or built on flawed measures.

HHS sets goals for expanding new Medicare payment models

By Paul Demko  |  January 26, 2015

The Obama administration wants 30% of payments for traditional Medicare benefits to be tied to alternative payment models such as accountable care organizations by the end of 2016. The administration also has set a goal of hitting 50% by the end of 2018.

Fresenius operates half of Medicare's lowest-rated dialysis facilities

Fresenius operates half of Medicare's lowest-rated dialysis facilities

By Sabriya Rice  |  January 26, 2015

Medicare's new five-star quality-rating system for dialysis facilities suggests significant disparities between the care provided by the nation's largest kidney-care companies. Far fewer Fresenius Medical Care facilities earned five- and four-star ratings than those of competitor DaVita Kidney Care.

CMS plans pilot to better estimate home health agency fraud

By Virgil Dickson  |  January 26, 2015

The CMS is developing a pilot program to determine just how many Medicare fraud cases are taking place in home health agencies. A contractor search is underway to help implement the initiative.

CMS  can order trials before OKing payment for new tech

CMS can order trials before OKing payment for new tech

By Virgil Dickson  |  January 24, 2015

The CMS will continue ordering some drug and device manufacturers to collect evidence on how well their technologies work before giving its final approval on reimbursement.

Data Points for Jan. 26, 2015

Data Points for Jan. 26, 2015

By Modern Healthcare  |  January 24, 2015

Data Points for the week of Jan. 26, 2015, covered the following topics: Medicare, insurance, costs, insurers

CMS posts dialysis ratings as industry protests

CMS posts dialysis ratings as industry protests

By Sabriya Rice  |  January 23, 2015

Consumers can now evaluate the quality of care at more than 5,500 dialysis facilities online with a five-star rating system the CMS rolled out Thursday. The program is part of a broader federal initiative to boost transparency and help Medicare beneficiaries compare quality.

Universal American still bullish on ACOs, as it exits more

By Melanie Evans  |  January 23, 2015

Insurer Universal American further scaled back its participation in the Medicare Shared Savings Program in the final months of last year, exiting another six accountable care organizations. The publicly traded health insurer remains the largest single participant in the program.

Even advanced ACOs struggle to expand model beyond Medicare

By Melanie Evans  |  January 16, 2015

By now, the accountable care organizations in the CMS Innovation Center's Pioneer ACO model were supposed to have shifted half their total business into risk-based contracts by selling the structure they honed in the federal program to Medicaid and private plans.

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