News
The Centers for Medicare and Medicaid Services is falling short in busting potential fraud by not verifying physician addresses and making sure they are currently licensed, according to a new Government Accountability Office report.
Most U.S. healthcare providers are simply unprepared to convert to new payment models, according to a recent survey by KPMG's Healthcare & Life Sciences Practice, which found only 15 percent of the 164 healthcare professionals surveyed said their finance departments can support capitation, bundled payments and quality-based payments.
The total deal value for the year is already at $395.8 billion, above 2014, when the industry booked $392.4 billion in deals.
Under the Affordable Care Act, state agencies largely retain the right to regulate premiums in their states, but so far only a handful have finalized premiums for the coming year, for which enrollment begins in November.
The economic collapse in 2008 changed everything for the new CFO Amy Floria, plunging Goshen, both the city and hospital, into crisis. But smart cost management has helped the system bounce back.
The Centers for Medicare and Medicaid Services quietly updated its database of hospital star ratings last week, and for many hospitals the news was good.
Medicare Trustees are projecting that the program's trust fund for hospital insurance coverage will remain solvent until 2030, unchanged from last year, and 13 years longer than the Trustees projected in 2009, before the passage of the Affordable Care Act.
Amid a planned acquisition by Aetna, Humana is still going forward with new models, including an expanded deal with one of several promising primary care ventures.
At the top end, the highest median amount paid for the procedure is $61,231 in the Sacramento, California metropolitan area. On the other hand, the Birmingham, Alabama region books the lowest cost paid at $15,494.
Primary care incentives for ACOs may not be strong enough to accomplish the goals of improving patient experiences, population health and high costs.