Where healthcare challenges find solutions
More insurers cut payment for patient consultations
The Centers for Medicare and Medicaid Services announced a change in how the codes should be used starting next year.
Insurer-provider wrangling limits bundled maternity growth
Providers and insurers agree bundled payments for prenatal care, delivery and postpartum care lower costs and boost quality, but squaring away payment terms has proven more tricky.
CMS to reweigh MIPS data for some physicians amid pandemic
Physician groups can submit extreme hardship applications to have 2021 quality and cost data re-weighted to account for the COVID-19 pandemic.
Providers push for higher reimbursement as Congress debates mental health legislation
Providers, patient advocates and some lawmakers are taking aim at health insurers, arguing that low payments and restrictions on coverage limit access.
CMS redesigns Direct Contracting into an ACO model
The new ACO model will incorporate health equity requirements, make changes to risk adjustment policies and more.
Medicare paid $6.6 billion in non-hospice care for hospice patients
Federal watchdogs say Medicare may be paying twice for hospice services, and for-profit hospices play a large role.
Florida failed to pay health claims for sick, needy children
Florida failed for nearly three months to pay tens of thousands of healthcare claims due to software glitches blamed on the corporate merger of its two largest payment vendors, officials and executives said.
Mayo, UnitedHealthcare dispute could set tone for all Medicare Advantage negotiations
By 2023, half of all Medicare beneficiaries are expected to be enrolled in a Medicare Advantage plan. This shift has already been realized in Minnesota.
HHS running out of money to pay providers for treating uninsured COVID-19 patients
Only about $7 billion remains to reimburse providers that treated, tested and vaccinated uninsured COVID-19 patients.
Medicare Advantage plans could see nearly 8% increase in revenue
Medicare Advantage plans could see a nearly 8% increase in revenue, but the methodology could consider health equity issues in the future.
Modern Healthcare is solely responsible for the editorial content of the Transformation Hub and submission is open to all organizations.