Reimbursement
A perfect storm of an aging demographic, lower premiums, high margins and CMS flexibility is behind MA success amid political Medicare for All.
There was a decrease in utilization among CHECK-enrolled patients, but the reduction was similar in the control group.
Savings produced by capping the teaching health center graduate medical education rate would allow the THC program to expand tenfold, research shows.
Higher telehealth rates would open doors for companies such as Amazon and WalMart to expand their healthcare business.
The order outlines sweeping policy and regulatory proposals including modifying Medicare fee for service payments to reflect the prices paid in MA plans and the commercial market.
Insurers can offer premium discounts or other incentives to engage in healthy activities, but questions remain as to whether wellness programs work.
With benefits costs expected to climb 5% in 2020, employers are engaging in efforts to stem the increases.
CMS is proposing that hospitals make public their payer-specific negotiated charges for a limited set of "shoppable" services or face civil monetary penalties, in a rule to go into effect on January 1, 2020.
Internal and external gaps in interoperability were the second most-cited barrier to VBC adoption, at 19.7%.
America's Essential Hospitals said it is working with lawmakers to stop $4 billion in cuts for 2020 from taking effect November 22.