Medicare & Medicaid
Star ratings represent billions of dollars in quality bonus payments. CMS has cost Elevance $375M, the complaint says.
This unsustainable business model and the financial burden are passed on to providers, says Everett Wilson, healthcare regulatory attorney at Polsinelli.
Providers have gotten a nearly 9% permanent cut to home health payment since 2023, says LeadingAge.
Time is running out for Congress to pass legislation to avert the cuts, AMA says.
MSSP earned shared savings payments totaling $3.1 billion, the highest since the program's inception.
Winners will be those who get and act on clinical data before patients get sick - and that’s a huge IT lift, says Dr. Don Rucker, former ONC head and current chief strategy officer of 1upHealth.
Short-term disparity between rates and medical cost trend may have reached its widest point in Q3, CEO says.
The star rating drop will cause Centene to lose an estimated $73M in gross revenue, lawsuit says.
Respondents say they are strongly considering not stocking the drugs because of potential low reimbursements from PBMs.
UnitedHealth has also filed a lawsuit, and Elevance says it is considering its options.