Reimbursement
CMS is also proposing increases in payment for many visit services, such as primary care, and changes impacting cancer treatment.
The lawsuit argues that Medicare is required to institute the payment model changes in a budget neutral manner.
Aspects of this proposed policy will affect nearly all hospitals paid under the Outpatient Prospective Payment System, CMS says.
HIMSS23
Because health organizations are paid by capitation, incentives are aligned to keep the patient healthy, says Ran Balicer, chief innovation officer at Clalit Health Services.
The concern is that the QBP overpays MA organizations and does not encourage quality improvement or help beneficiaries select plans.
The decrease is due in part to a permanent behavior assumption adjustment.
For hospital-based facilities, CMS projects an increase in total payments of 2.6%.
More than two-thirds of individuals who had Medicaid during the pandemic had their coverage terminated for procedural reasons, according to KFF.
One allows managed care plans to complete certain parts of the renewal form on behalf of Medicaid beneficiaries.
HIMSS23
CareSignal, which is part of Lightbeam, takes population health enablement strategies and metrics to clinicians, says CareSignal CEO Blake Marggraff and Lightbeam president Jerry Shultz.