Medicare & Medicaid News

‘Unjustified’ Premium Increases Obstruct ACA’s Transparency

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Covered California – which encompasses almost 13 percent of all Marketplace enrollees paying for nationwide coverage – announced yesterday a “modest” anticipated 4 percent...

CMS Approves Press Ganey to Administer PQRS CAHPS Survey

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On July 27, 2015, Press Ganey Holdings, Inc. announced in a press release that it will be one of the vendors approved by the Centers for Medicare & Medicaid Services (CMS) to administer the...

As Medicare Turns 50, Does It Still Make Financial Sense?

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As Medicare’s 50th birthday approaches, critics begin to question whether the program should be rescued and updated for today’s health economy, or if it should be phased out and...

Is CMS’s Hospital Quality Star Rating System Non-Compliant?

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The Hospital Quality Star Rating System from The Centers for Medicare and Medicaid Service (CMS) is facing scrutiny. Some industry-wide trepidation exists about whether or not CMS’s Hospital...

CMS Trustees Report Historic Low in Medicare Cost Growth

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Growth in Medicare costs remains low, according to the Trustees report released on July 21 by the Centers for Medicare & Medicaid Services (CMS). The Trustees report indicates that the Medicare...

New Growth in Home and Community-Based Services Spending

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The Centers for Medicare & Medicaid Services (CMS) has released its “milestone” 2013 Medicaid Expenditures for Long-Term Services and Supports Report. According to the Center for...

AK Gov. Proposes Sept. Medicaid Expansion Reform Under ACA

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Medicaid expansion may be the key to cutting state spending. The governor of Alaska, Bill Walker, recently notified a state committee that he plans to accept both federal and Mental Health Trust Fund...

Medicare Care Choices Model Awards Drive Choice, Quality

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The Centers for Medicare & Medicaid Services (CMS) is focused on helping Medicare beneficiaries, their families, and loved ones acquire the right type of healthcare. This week, CMS announced...

CMS Conducts Hospital Quality Star Rating System Run-Through

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Buckle up. The Centers for Medicare & Medicaid Services (CMS) is giving its Hospital Quality Star Rating System a vigorous test drive to review its production process, increase system understanding,...

Value-Based Purchasing Model Revises Home Health Payments

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In an ongoing effort to advance the quality of economically profitable healthcare, the Centers for Medicare & Medicaid Services (CMS) looks again to the promotion of care quality. CMS’s new...

Summary of CMS’s Top 5 Proposed Payment Rules, Revisions

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The Centers for Medicare & Medicaid Services (CMS) has continuously released a steady stream of payment policies and physician fee schedules. As RevCycleIntelligence.com reported in a summary of top...

CMS’s Fraud Prevention System Thwarts $820M in Payment Abuse

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A 10:1 return on taxpayer money is a rare feat. Nonetheless, an advanced state-of-the-art analytics system – the Fraud Prevention System – courtesy of The Centers of Medicare & Medicaid...

Praise for Patient-Centered Payment Models, Bundled Payments

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The Centers for Medicare & Medicaid Services (CMS) apparently gets a big thumbs up this week. Leading consumer advocacy group, the National Partnership for Women & Families (NPWF), openly...

What is the New Future of Value-Based Payment Programs?

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Medicare’s value-based payment programs provide physicians with purposeful information that can be intelligently acted upon to resultantly strengthen care quality. As the shift...

CMS Proposes Post-SGR Repeal Physician Fee Schedule Update

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The Centers for Medicare & Medicaid Services (CMS) has released a projected update to the physician payment schedule. CMS’s proposal marks the first post-Sustainable Growth Rate (SGR) repeal...

How does the ACA Impact Providers’ Trust of Payers?

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How are those healthcare payers participating in Affordable Care Act (ACA) implementation performing? Perhaps pretty well, according to a tenth annual PayerView report card and ninth annual Payer Trust...

Will Inefficient Financial Healthcare Reform Kill the ACA?

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Is the Affordable Care Act (ACA) hurling the healthcare industry further into the red? The answer is a definite yes, according to a recent RevCycleIntelligence.com article about key...

Senate Finance Committee, NKF Address Medicare Spending

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The vast majority of Medicare dollars – 93 percent – accounts for chronic illness. As reported by RevCycleIntelligence.com, a recent legislative proposal from the Senate Finance Committee...

CMS Shares $62B in Medicare Payment Data, Doctor Utilization

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The Centers for Medicare & Medicaid Services (CMS) announced the third annual release of its Medicare hospital utilization and payment data at this week's annual Health Datapalooza...

ACA Adds Billions in Bureaucratic Waste, Administrative Costs

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The Affordable Care Act (ACA) will prove a tremendous financial burden to the healthcare industry. Although the administrative costs of healthcare are projected to remain high throughout 2022,...