Joint replacement, spinal fusion and gastrointestinal surgeries were on average $4,229 less when providers charged a set price.
Experts recommended that CMS promote equity with advanced payment models that prioritize reducing disparities and tie financial performance to health equity outcomes.
Insiders worry that the Geographic Direct Contracting model is too complicated to put into practice, which could frustrate Medicare beneficiaries and make it more difficult to coordinate and manage care.
The American Hospital Association is asking the federal government to restrict UnitedHealthcare policies that threaten reimbursement for diagnostic lab tests and specialty drugs.
Cigna will no longer require prior authorization for some CT scans of the heart, a move that providers said will relieve administrative burdens among physicians and result in better outcomes for patients.
CMS rejected more than 60% of the exceptions that would preserve hospitals' higher reimbursement rates if they could prove their off-campus outpatient departments were in construction in 2015.
Over the past few years, an increasing number of regional insurers have launched virtual-first plans for the first time, in a move to differentiate themselves from larger insurers in their markets.
The Medicare Payment Advisory Commission doesn't expect the recommendations to decrease Medicare beneficiaries' access to care or lower quality.
Overall, the 37 ACOs earned about $461.9 million in shared savings. The model is now in its final performance year.
Specialty physician groups successfully fought to mitigate pay cuts after the Medicare Physician Fee Schedule was released.
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