CMS has issued interpretative guidance on its healthcare worker vaccine mandate following the Supreme Court’s decision to allow the mandate to be enforced while some states challenge it in courts. The guidance released a day after the Supreme...
More InfoSmall group coverage did not pursue the trends that many experts anticipated after the Affordable Care Act went into effect. From 2013 to 2020, small group coverage has maintained a fairly stable environment, researchers from the Urban Institute...
More InfoCMS is proposing a new rule that aims to cut prescription drug costs, increase contract vetting and improve health equity, according to a Jan. 6 news release. The proposed changes primarily target Medicare Advantage and Part D plans. CMS also...
More InfoMedicare Part B spending on laboratory tests ticked up to $8 billion in 2020, driven largely by new COVID-19 diagnostics reimbursements, even while spending on other types of tests declined, according to a new report released by the U.S...
More InfoThe Centers for Medicare & Medicaid Services (CMS) will enforce its COVID-19 vaccination requirement in 25 states, the District of Columbia, and other territories, according to an update released on December 28, 2021. CMS is enjoined from...
More InfoBreak out your pen and paper because if you haven’t already started your list of new year’s resolutions, the past 12 months have given us plenty of ‘New Year, new me’ examples to take note of. From ratified legislation and appointed government...
More InfoCOVID-19 continued to affect the industry, which has plowed forward with expanded offerings, digital transformation and other bold moves. It was difficult to predict trend lines for the payer and health insurance industry in 2021, largely because...
More InfoOn November 2, 2021, the Centers for Medicare and Medicaid Services (“CMS”) issued its Calendar Year (CY) 2022 Physician Fee Schedule (“PFS”) Final Rule. In this post, we sample some key highlights from the Final Rule. For more detail, take a...
More InfoIn November 2021, the Centers for Medicare and Medicaid Services (“CMS”) issued the Physician Fee Schedule Final Rule (“Final Rule”) which includes several telehealth policy updates that will go into effect in calendar year 2022.1 As a result of...
More InfoNew data from LAN shows modest progress with value-based reimbursement adoption in 2019 and 2020. But some programs, like Medicare Advantage, are moving to financial risk faster than others. Most healthcare payments made in 2020 were tied in some...
More InfoProviders must rely on population health management strategies and effective risk stratification to succeed at value-based care. During the COVID-19 pandemic, organizations witnessed the consequences of fee-for-service as providers and patients...
More InfoUrgent care centers have assisted in the country’s COVID-19 response, but their value extends well beyond the pandemic. The past decade has witnessed a surge in the number of urgent care centers, with more than 9,000 of these...
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