In April, the U.S. Department of Health and Human Services (HHS) announced five new alternative payment models for primary care, known as the CMS Primary Cares Initiative. The five alternative payment models are: Primary Care First Primary Care First – High Need Populations Direct Contracting – Global Direct Contracting – Professional Direct Contracting – […]
Dual eligible Medicare Advantage beneficiaries had 42.1% less emergency room visits than their fee-for-service counterparts. The cost of care and rate of hospitalizations for dual eligible Medicare Advantage (MA) beneficiaries was considerably lower than dual eligibles under fee-for-service (FFS), according to an Avalere Health study released Tuesday evening. Dual eligible Medicare Advantage (MA) populations averaged healthcare […]
President Donald Trump said it’s time for Congress to pass a law that stops hospitals and insurance companies from hitting patients with surprise medical bills. “We’re going to hold insurance companies and hospitals accountable,” Trump said during a news briefing Thursday. A bipartisan group of senators have been working on a bill addressing the issue, with the plan to […]
Healthcare is a top priority for American voters and there aren’t dramatic differences by ideology, according to a new survey. Key Takeaways Thirty six percent of Americans ranked healthcare as the most important policy issue facing the nation’s future. Seventy two percent of Americans responded that they were satisfied with the healthcare they received while […]
Keen on giving Americans in federally-funded programs more control over their healthcare, the U.S. Department of Health and Human Services (HHS) has been working closely with past and present administrations to establish regulations governing electronic health information (EHI). On March 4, the Office of the National Coordinator for Health Information Technology (ONC) published a proposed […]
Proposed rules also include new payment models. The Centers for Medicare & Medicaid Services (CMS) has been quite busy these last few weeks issuing the proposed payment rules for 2020 and making some other announcements. Here is an update on other regulatory activities of interest. On April 22, 2019, the CMS Innovation Center announced the […]
To remain fiscally viable, hospitals and health systems must ensure reimbursement is collected properly and in a timely fashion. Healthcare’s “perfect storm” — the ever-increasing cost of care paired with the complexity of technology and rising expenses — has intensified this pressure, according to David Millen, vice president of information technology and digital transformation at […]
The accelerating challenge around patient needs’ calls for new technology and automation, but on a personal level. As hospitals turn to technology to overhaul the patient experience and improve profits, a range of vendors are bringing new products and outsourced services to meet that demand with artificial intelligence, data analytics and natural language processing as […]
CMS has released the inpatient psychiatric facility proposed rule. Approximately $75million is projected to be paid to inpatient psychiatric facilities (IPF), according to the Centers for Medicare & Medicaid Services (CMS) proposed 2020 inpatient prospective payment system (IPPS) released on April 19. IPF-PPS applies to inpatient services for psychiatric hospitals and distinct psychiatric units of […]
Recently proposed rules would boost FY 2020 Medicare payment rates for several post-acute providers, including skilled nursing facilities and hospices. April showers bring May flowers. But, this year, they are also bringing a slew of new Medicare payment rate proposals, including reimbursement and quality reporting updates for several types of post-acute care providers. CMS recently […]