Medicare & Medicaid
Different states have different methods for identifying 340B drugs billed to programs, findings showed.
On average, physician-led ACOs produced almost 7 times the amount of Medicare savings per beneficiary than hospital-led ACOs.
The anticipated savings would increase in a scenario in which biosimilars made up a larger portion of the total market share.
The bonus pool size in 2018 was $6.3 billion, which goes to 4-star and above plans as $500 per member, per year.
UTC Laboratories was charged with billing Medicaid for unnecessary pharmacogenetic testing.
The data also shows encouraging employment opportunities for PAs, with most receiving multiple job offers.
There are 1,200 more MA plans than in 2018 and in 2020 a greater number rate 4 stars or more, CMS says.
A perfect storm of an aging demographic, lower premiums, high margins and CMS flexibility is behind MA success amid political Medicare for All.
Example of changes is allowing a hospital to donate free cybersecurity software to each physician that refers patients to its hospital.
The Oregon model may promote more efficient use of resources, driven by primary care and financial incentives for care coordination.