Medicare & Medicaid
Most states have gotten or are seeking the Section 1332 waivers to establish a reinsurance program to fully or partially reimburse insurers that are covering claims for high-risk beneficiaires.
Costs for two- and four-person families rose despite overall premiums being relatively flat compared to last year.
Participation almost doubled year-to-year, while the number of clinicians taking part in MIPS declined.
As they have become more widespread, ACOs have employed a variety of care management and coordination strategies.
While CMS says it is now allowing therapist assistants to perform services, Premier says the agency's definition requires a skilled professional.
Current rule makes no sense as it applies only to fee-for-service and most Medicaid beneficiaries are now served through managed care, stakeholders tell CMS.
Moody's credit analysts called the move positive for health insurers that own large PBMs.
CMS said it would encourage development of wearable or implantable artificial kidneys through cooperation between developers and the FDA.
The ACA is not a Jenga tower that will collapse upon removing the piece of the individual mandate, America's Health Insurance Plans argues.
Overall, hospitals in the CJR model saw a 3.7% decrease in average episode payments for lower extremity joint replacements.