Where healthcare challenges find solutions
New drug payment models could cut Medicaid spending
State healthcare budgets grew by 7.3% from 2017 to 2018. New drug payment models can help states get Medicaid costs under control, but they face obstacles, according to a new report.
Repealing Medicaid access rule could vastly lower provider pay, say opponents
The CMS wants to repeal a rule that requires states to report on fee-for-service Medicaid payments. Supporters say it will reduce regulatory burden, but opponents argue that it will hurt patients and providers.
Americans 'fed up' with high healthcare costs, surprise billing, Verma says
CMS Administrator Seema Verma said transparency and value-based payments are the future of American healthcare. If hospitals don't accept it, Medicare for All could be on its way.
Cigna aims to expand affordable access to gene therapies
Health insurer Cigna Corp. has come up with a new program that it hopes will be the key to expanding affordable access to gene therapies as more come on the market in the coming years.
Value-based payments are coming to post-acute care, says MedPAC
MedPAC is developing a value-based payments program for post-acute care settings. The commission says it will reward quality improvements across all post-acute settings.
California surprise billing law takes spotlight in federal fight
As federal lawmakers eye a benchmark proposal to end surprise medical bills, providers and insurers tell conflicting stories about California's experience with a similar policy.
Health insurers slam CMS proposal to alter Medicare Advantage audits
Insurers and their trade groups urged the federal government to scrap proposed changes to Medicare Advantage plan audits, warning the changes could result in higher costs and reduced benefits for seniors.
Blue Shield of Calif. aims to help independent doctors with value-based care
Blue Shield of California's new technology company will partner with the California Medical Association and Aledade to offer doctors tools to improve patient health outcomes while remaining independent.
Value-based health insurer contracts growing in number, but not risk adoption
While value-based payment contracts are popular among providers and insurers, the amount of reimbursement actually at risk remains slim.
Minnesota Blues strikes up outcomes-based cancer care arrangement
Blue Cross and Blue Shield of Minnesota and Minnesota Oncology have entered a five-year value-based arrangement to pay for cancer care based on patient outcomes rather than the number of services performed.
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