The CMS Innovation Center – otherwise known as CMMI – has been the federal government’s key instrument for healthcare payment and care delivery reform. But lately, policymakers and...
Oncology practices participating in CMS’ Oncology Care Model (OCM) are willing to take on two-sided risk, according to a survey conducted by the Community Oncology Alliance (COA).
The...
University of Florida Health (UF) researchers have partnered with the Health Services Advisory Group (HSAG) to complete a new quality measure for CMS to evaluate care in psychiatric hospitals...
A recent analysis conducted by the Health Care Cost Institute (HCCI) is raising questions about the efficacy of a consumer-centered hospital price transparency requirement slated to take effect next...
Medicare Advantage enrollees had a 2.8 percentage point lower probability of being admitted to a highly rated hospital compared to traditional Medicare enrollees, according to a report from Brown...
The national disparity between gross charges for hospital procedures is substantial, at an average of 297 percent difference between the lowest and highest gross charge for each individual procedure,...
The number of accountable care organizations (ACOs) in the overhauled Medicare Shared Savings Program (MSSP) assuming downside financial risk doubled from 93 ACOS at the start of 2019 to 192 at the...
Next Generation accountable care organizations (ACOs) reduced spending by about 1.11 percent in 2018, returning more than $184 million to the Medicare Trust Funds, according to new program results from...
Administrative healthcare spending totaled $812 billion in 2017, representing over one-third (34.2 percent) of total expenditures for physician practices, hospitals, long-term care, and private payers,...
The Trump administration announced on Monday that it has picked Brad Smith to serve as director of the CMS Innovation Center (CMMI), where he will oversee the development and testing of value-based...
Over 84,200 more eligible clinicians sufficiently participated in one of the Quality Payment Program’s Advanced Alternative Payment Models (APMs) in 2018 compared to the previous year, according...
The American Medical Association (AMA) recently issued a checklist for physician practices to use when adopting evaluation and management (E/M) coding and documentation changes slated to take effect...
Tying Anti-Kickback and Stark Law reform to the level of financial risk providers assume creates more complexity and burden and could impede the transition to value-based care for physicians, advocacy...
HHS’ Office of Inspector General (OIG) is taking steps toward “much needed reform” of Medicare fraud laws, but more can be done to remove the value-based care barriers presented by...
Hospitals will still get paid the reduced rate for certain clinic visits in 2020 despite a federal judge striking down the site-neutral payment policy earlier in 2019.
In an opinion filed on Dec. 16...
The National Association of Accountable Care Organizations (NAACOS) recently announced the formation of the Direct Contracting Taskforce, which offered tools for participation in the latest accountable...
Seven healthcare organizations in Michigan recently signed on to participate in a new shared-risk payment model with Blue Cross Blue Shield of Michigan that will hold the providers accountable for...
CMS announced in a newsletter last week that the agency will automatically reprocess claims for hospital outpatient services performed in calendar year (CY) 2019 to abide by a federal judge’s...
Hospitals are fed up with CMS’ plan to survey 340B hospitals to obtain drug acquisition cost data for drugs covered under the program. In a letter to CMS, 340B Health recently asked CMS to...
Supplemental hospital payments from Medicare were overstated by $502 million for 60 hospitals because of limits on the reconciliation process for outlier payments that stops contracted reviewers from...
