While the Centers for Medicare and Medicaid Services (CMS) are moving forward with tighter regulations on the Medicare Advantage (MA) program, the Heritage Foundation argues that freeing MA from the constraints of Medicare Fee-For-Service (FFS) payment rates and making it the default Medicare enrollment system would offer a solution to...
Last week, the Health Care Payment Learning and Action Network (LAN) published its 2022 Methodology and Results report, which is the result of a data collection survey of health plans and states for an account of how money moves through alternative payment models and how these programs function in terms of barriers and access.
In...
A new analysis by ATI Advisory for Better Medicare Alliance is the fourth in a series of data briefs over 2021 that examine Medicare coverage arrangements related to demographics, outcomes, and spending in the dual eligible population. The research compiled by this series suggests that dual eligible beneficiaries are more likely to...
Last April, the Centers for Medicare and Medicaid Services (CMS) announced a plan for a new Primary Care First demonstration. Earlier this month, CMS released the final details for the program which has been delayed to launch until January 2021.
The Primary Care First program is a risk-based program offered to 26 regions, with a...Arizona News
Starting Oct. 1 therapy payments to nursing facilities will shift to a value-based model, emphasizing patient needs over the amount of services provided. The Patient Driven Payment Model (PDPM), a more individualized approach, aims to reduce inflated billing by basing payments on patient's medical characteristics.
The new approach...National News
An industry moving away from fee-for service needs physicians committed to the change.
For many years, physician behavior has been oriented to maximizing patient visits and procedures.
Healthcare Finance quotes Dr. Debbie Zimmerman, chief medical officer at Lumeris:
Where we find the heaviest lift in any institution is changing...National News
American Medical Association used its Physician Practice Benchmark Surveys which comprise practice arrangement and payment information on active U.S. physicians.
We hear a lot about Alternative Payment Models, their use and successes. Becker's Hospital CFO Report delineates "Five Things to Know" from the AMA paper:
1. In 2016, more...National News
A study commissioned by the Association for Community Affiliated Plans (ACAP) looked at potential savings of Medicaid capitated care with national and state-by-state estimates.
Managed care is poised to become the dominant payment model for Medicaid, the report notes. In 2010, capitated managed care represented only a quarter of...
