VA hopes to adopt value-based payments to improve healthcare

By Shannon Muchmore  |  November 18, 2015

The Veterans Affairs Department on Wednesday presented a plan to Congress for overhauling the way veterans receive care outside the VA. It would move toward value-based provider payments and would need at least $1.5 billion to get it started.

Medicare keeps test of joint-replacement bundles mandatory

Medicare keeps test of joint-replacement bundles mandatory

By Virgil Dickson  |  November 16, 2015

The CMS will require hospitals in 67 areas, including Los Angeles and New York City, to participate in a test of bundled payments for hip and knee replacements. The final rule pushes back the start date three months to April 1, 2016.

N.J. hospital sues Horizon Blues for exclusion from discount plan

By Maria Castellucci  |  November 10, 2015

St. Peter's University Hospital, New Brunswick, N.J., has filed a lawsuit against Horizon Blue Cross and Blue Shield of New Jersey, claiming the hospital was wrongfully excluded from a discount insurance plan called Omnia Health Alliance.

High court to hear arguments on insurer reimbursement

By Lisa Schencker  |  November 07, 2015

The U.S. Supreme Court on Monday is scheduled to hear oral arguments in a case that pits insurers against beneficiaries when it comes to who's entitled to money won in court after an injury.

Providers say they'll campaign against cuts to colonoscopy payments

By Virgil Dickson  |  November 03, 2015

Providers say they may stop taking patients who are often at high risk of being diagnosed with colon cancer because of cuts to colonoscopy Medicare payments. The CMS says it's following recommendations that found ​​that providers were being overpaid for the tests.

Experts are skeptical value-based purchasing program is helping boost quality

Experts are skeptical value-based purchasing program is helping boost quality

By Melanie Evans  |  October 31, 2015

Four years into Medicare's value-based purchasing program, more hospitals than ever are earning bonuses, and the top-performing ones are getting bigger rewards. But policy experts and hospitals themselves remain dubious that the program has much influence over healthcare quality.

Editorial: A bungled bundle

Editorial: A bungled bundle

By Merrill Goozner  |  October 24, 2015

Recent history has proved poorly designed payment reforms have unintended and unwanted consequences. The CMS is on the cusp of making that mistake with its plan to bundle payments for replacing knees and hips.

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