Medicare & Medicaid
Hospital margins of 10 percent and greater are the result of insurers paying too much, study says.
The value-based agreement will reimburse physicians based on patient outcomes.
CMS will now post new performance information on their website, including quality-of-care deficiency findings, and will refine the process for gauging an AOs ability to assess compliance.
Financial penalties for readmissions are mandated by the Hospital Readmission Reduction Program, a part of the Affordable Care Act.
Voluntary bundled payment model is tied to performance and also qualifies as an APM for MACRA.
Reforms to the local coverage determination process will increase transparency and patient engagement to ensure beneficiaries can get the latest therapies and devices.
Hemodialysis costs Medicare $80,000 per patient yearly; Researchers say use of nephrologist to slow progression could save Medicare $730 million.
Seniors can compare the cost and benefit of enrolling in traditional Medicare, or signing up for Medicare Advantage.
The penalties for some facilities will be as much as 3 percent, the maximum allowed under federal law, which can translate into tens of thousands in lost revenue.
MA enrollment is projected to increase while plans offer new types of supplemental benefits, CMS says.