Reimbursement

Overall, Medicaid insurers in the Golden State made $5.4 billion in profits from 2014 to 2016, in part because the state paid higher rates during the inaugural years of the nation's Medicaid expansion under the Affordable Care Act.

Billing data from Medicare and private insurance billing nationwide shows spending on urine screens and related genetic tests quadrupled from 2011 to 2014 to an estimated $8.5 billion a year

Program, which covers 8 million children, has garnered largely bipartisan support since it took effect in 1997.

For instance, 10 percent weight in the cost performance category is to ease the transition to a 30 percent weight in 2021.

But changes to the safety and clinical care domains will come in 2019, so preparation is key.

Physician fee schedule final rule also updates payments for biosimilars, pays for more telehealth services and provides detail on participation in APMs under MACRA.

Together, MDwise and McLaren Health Plan will serve more than 620,000 members, making it one of the region's largest system-run plans.

To integrate care, provide more services and stay competitive, hospitals are still building outpatient facilities.

The new program, and the expected final MACRA rule, are proof that the new administration is serious about scaling back requirements for providers.

The final rule will also allow for higher outpatient payment when Medicare beneficiaries receive certain procedures in a lower cost outpatient department.