Emergency Declarations on the federal and state levels can potentially cause discrepancies in coverage for both private providers and state-provided coverage services like Medicare and Medicaid. Following these declarations, both private insurance companies and the Centers for Medicare & Medicaid Services (CMS) issued guidance for...Arizona News
The Centers for Medicare and Medicaid Services (CMS) is rolling out a new “Emergency Triage, Treat, and Transport” (ET3) model designed to cut costs and increase flexibility for ambulance care teams treating Medicare Fee-for-Service (FFS) beneficiaries.
Last week, they announced the 205 ambulance operators in 36 states...National News
The study, published earlier this month in The Lancet, provides some scientific scaffolding for the ambitious healthcare overhaul central to Elizabeth Warren and Bernie Sanders’ presidential campaigns.
It predicts Medicare for All (M4A) would save the country 13% or $450 billion in health care expenditures each year and save 68,000...National News
The Centers for Medicare & Medicaid (CMS) proposed to extend the Comprehensive Care for Joint Replacement (CJR) model for an additional three years.
Currently set to expire at the end of this year, the proposal would extend the Medicare bundled payment model until Dec. 2023. It provides participating providers with a fixed...National News
The Medicare Payment Advisory Commission (MedPAC) voted unanimously to maintain updates to Medicare physician payments planned for 2021 -- with some caveats.
Primarily, the commission was concerned with the lack of data available on physician expenses. They stressed a need to better understand these expenses to improve the...White Papers, E books, Reports and more
A study recently published by JAMA Surgery set out to evaluate the health outcomes of Medicare beneficiaries who have undergone emergency general surgery (EGS). The study’s central question was: How does this population fare compared to those with acute medical conditions, like pneumonia, heart failure, and acute myocardial...National News
Last week, the House passed a Pelosi-backed prescription drug bill that would allow Medicare to negotiate with pharmaceutical companies for lower prices.
If signed into law, H.R.3 would also establish a $2,000/year cap on out of pocket costs for Medicare patients and require drugmakers to pay rebates if their drug prices rise faster...National News
This month, the Centers for Medicare and Medicaid Services (CMS) released the National Health Care Spending Report In 2018. The report demonstrated that health spending in the United States grew faster in 2018 than it had in the two previous years.
The Dec. 5 report is a compilation of National Health Expenditure data released...Data Resources
Following an annual data report by the Centers for Medicare & Medicaid Services (CMS), 77% of skilled nursing facilities (SNFs) participating in the Value Based Purchasing program will receive reduced reimbursements from Medicare and only 23%, or 2,909 SNFs will see a bonus in FY 2020.
Last year in Arizona, 138 SNFs participated...National News
A recent report from the Government Accountability Office (GAO) found that discharges from hospice care prior to the death of a patient is much higher among for-profit hospices than similar nonprofit institutions.
The report also found that for-profit hospice care providers were less likely to visit dying patients within three days of...National News
The price of beds in skilled nursing facilities has risen over $1,000 in the past year, according to a quarterly report by Irving Levin Associates.
In 2018, skilled nursing facilities’ (SNFs) bed prices fell an average of 3.9 percent for the final quarter of 2018 with a total decline of 7.9 percent for the year. Bed prices...Arizona News
The Urban Institute released a highly anticipated study Oct. 15 regarding the viability and expenses of health insurance coverage reform plans proposed by Democratic Party candidates designed to move the country towards universal or near-universal coverage.
With the 2020 Democratic Primary and debates on healthcare reform heating up,...National News
One of the country's oldest nonprofit health insurance plans allegedly exploited Medicare of millions; Seattle-based Group Health Cooperative was taken to federal court in a whistleblower case.
Filing suit against the health plan is one of the company's former medical billing managers, Teresa Ross, who alleges that Group Health...Arizona News
In a speech given on Monday at the Better Medicare Alliance 2019 Medicare Advantage Summit, Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma voiced concerns about the consequences a single-payer healthcare system including its impact on innovation with the elimination of private insurers.
Verma explicitly...Arizona News
The Centers for Medicare and Medicaid Services has finalized a rule intended to make prices more transparent with Medicare Part D drug plans and allow plan sponsors to use cost-cutting tools such as step therapy under certain circumstances.
"CMS is delivering on price transparency, because patients have a right to know the cost of...National News
Across the nation, hospitals treating patients with private health insurance were paid overall 2.4 times the Medicare rates in 2017, according to the RAND analysis. The difference was largest for outpatient care, where private prices were almost triple what Medicare would have paid. The study illustrates the widening chasm between what...National News
The Centers for Medicare and Medicaid Services (CMS) acknowledged the importance of social determinants of health in a Wednesday blog post encouraging healthcare providers to utilize new resources and data-driven approaches to addressing non-clinical factors.
The blog post, by Cara James, director of the CMS office of Minority...Arizona News
Health clinics in Safeway stores across Arizona have gone completely automated, combining artificial intelligence, augmented reality and telemedicine to offer healthcare services in under 30 minutes. Patients worried about an injury or potential illness provide their physical information to a computerized program armed with artificial...National News
Debates on restructuring the nation’s healthcare system could not have hit its peak at a more appropriate time. The financial future of Medicare and Social Security, two of the nation’s pillar government programs, looks grim and in less than a decade Medicare could potentially become insolvent—already slated to run a deficit by...National News
Payment rates will increase an average of 2.53 percent for 2020. This new rate is 1.53 percent higher than originally projected due to new estimates of medical cost growth, but less than the 3.4 percent raise MA plans were given in 2019.
Also included in the proposal is a loosening of the non-health related supplemental benefits...