Tag: Healthcare Quality

Medicare Physician Fee Schedule 2025

2025 Medicare Physician Fee Schedule Proposed Rule By CMS

On July 10, 2024, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that announces and solicits public comments on proposed policy changes for Medicare payments under the Physician Fee Schedule (PFS), and other Medicare Part B issues, effective on or after January 1, 2025. The calendar year (CY) 2025 PFS proposed […]
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Healthcare Price Transparency Rule

CMS Issues Long-Awaited, Controversial Final Rule on Price Transparency

  A long-awaited and controversial final rule on healthcare price transparency was released Thursday by the federal government. The rule, mandated under a June 2019 executive order by President Donald Trump, requires private group health plans and individual health insurance market plans to disclose pricing and cost-sharing information in a consumer-friendly format. The mandate, which takes effect on January […]
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Healthcare Price Transparency Rule

New Healthcare Price Transparency Rule – The Best, Worst, and Most Realistic Case Scenarios

The American Hospital Association has filed a lawsuit to block the rule. On Nov. 15, 2019, the Trump Administration proposed a new healthcare price transparency rule that would basically require hospitals to explain how much a medical service would cost before a patient receives treatment. This rule is due to become effective in January 2021. The […]
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Medicaid Payments

Adjusting Medicaid Payments for Social Determinants to Boost Care

Using a per-person adjustment for Medicaid payments to hospitals would address social determinants of health and help hospitals fund more comprehensive care, experts say. Adjusting Medicaid payments for social determinants of health would help address the broader social needs of children and cost restraints at safety-net hospitals, according to researchers from the Northwestern University Feinberg School of […]
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Medicare Advantage for Dual Eligibility

Medicare Advantage Dual Eligible’s Have Fewer ER Visits Than Those Under FFS

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 […]
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Medicare for All Allzone Management Solutions

Healthcare Remains Primary Concern for Voters, with Strong Support For ‘Medicare-For-All’

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 […]
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Medicare Quality & Cost

Better Quality, Lower Health Care Costs – Providers & Payers Share Risk

Denied claims are one of physicians’ chief complaints when it comes to dealing with payers. To a certain extent, every practice deals with claim denials. It’s those practices that eliminate the most common reasons that experience a smoother revenue cycle and find greater financial success. News Brief A capitation payment model results in better value […]
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