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.
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.
Pioneer Community Hospital of Newton, Miss., will close Dec. 1 after losing a key federal funding status, becoming the fourth Mississippi hospital to close since 2013.
Medicare payment changes are likely to affect how rehabilitation providers serve patients.
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.
The CMS has reversed course on a coverage decision that advocates argued would have blocked access to needed prosthetics for more than a million people.
Regarding the Oct. 26 editorial “A bungled bundle”, bundled payments are nothing new.
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 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.
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.
A proposed change to how hospital-owned ambulatory surgery centers are paid could further suppress the appetite of hospitals to own these capital-intensive outpatient facilities.
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.