Where healthcare challenges find solutions
As providers and the government try to lower healthcare costs, much of the action rests on lower reimbursement. Meanwhile, patients increasingly are reaching into their own pockets to cover their healthcare costs. They want price transparency and convenient ways to pay their bills, and providers want to maintain healthy margins. Read more about how payment innovations affect the industry.
A Medicare model aimed at patients who wanted hospice as well as curative care did not do well in its first year because hospice providers fled the program and doctors were not interested in participating.
As Medicare funds dry out, the OMB believes simplifying value-based pay models and reducing spending on care delivery could be crucial to shoring up the program.
Providers warned the CMS that its proposal to let thousands of doctors continue to sit out of the Merit-based Incentive Payment System undermines their investments to comply with the program as well as the health of seniors.
Intermountain Healthcare, Anthem and other healthcare leaders have launched an alternative payment model intended to provide patients with long-term, comprehensive and integrated care for addiction recovery.
The CMS' final inpatient pay rule ends a long proposed 25% rule affecting long-term care hospitals' Medicare reimbursements. The rule also finalized plans to overhaul the meaningful use program to offer incentives for interoperability.
As the CMS charts a path to level pay for outpatient services, it's also leading toward a head-to-head battle with powerful hospital lobbying groups as some providers win and lose with site-neutral payments.
Consumers can now sign a petition that lobbies Maryland providers and insurers to reveal their costs via the state's updated price transparency website.
Tennessee will ask for federal approval to update how it doles out uncompensated-care funds to hospitals. The move comes as facilities in the state face rising expenses and decreasing patient revenue.
A federal court has received the American Hospital Association's ideas on reducing the huge backlog of denied Medicare claims. A federal judge may mandate HHS to follow some or all of the ideas in order to curb the ever-growing number of appeals.
Provider groups have just two months to decide about participating in the CMS' Bundled Payment for Care Improvement Advanced program, but they still don't have the claims data they need to make that decision.
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