Quality and Safety
In the end, the program has shifted money away from physicians who treated sicker, poorer patients to pay for bonuses that rewarded practices treating richer, healthier populations.
As the popularity, and profitability, of urine tests has expanded, so has the potential for fraud and malpractice.
Insurers, providers, pharma urge CMS to reconsider allowing states to set essential health benefit benchmarks.
But study suggests the U.S. as a whole is not doing particularly well when it comes to pulling back on outdated procedures.
Integration with providers, narrow network ACO models, speaking members' languages and improving patient experience all key to earning, and keeping, an overall 5-star rating.
Expensive branded drugs, diagnostic testing and imaging for some patients prior to low-risk surgery and population-based vitamin D screening all make the list.
Hospitals and other providers spend nearly $39 billion a year solely on the administrative activities associated with regulatory compliance, AHA says.
A total of 30 rural hospitals are taking part in the budget neutral program that pays higher Medicare rates.
New proposed rule offers insurers more plan flexibility and eases regulations.
Proposed rule would update star rating methodology, save Medicare close to $200 million over 5 years.