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.
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.
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.
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.
A whistle-blower is accusing the Cleveland Clinic of performing unnecessary tests on patients to squeeze money out of the government. The government, however, declined to join the case.
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.
Rep. Paul Ryan of Wisconsin is like the dog that caught up to the car he was chasing. Now what?
Data Points for the week of Jan. 26, 2015, covered the following topics: Medicare, insurance, costs, insurers
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.
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.
There's only one outstanding issue left to resolve before Congress can pass a permanent “doc fix”: how to cover the roughly $140 billion price tag.
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.