Over the weekend, Senate Democrats came together to pass the massive Inflation Reduction Act, which includes a proposal to give Medicare the power to negotiate certain drug prices, as well as a three-year extension of Affordable Care Act (ACA) subsidies to insurers in the form of tax credits that were initially passed as part of the...National News
This week, the Medicare Payment Advisory Commission (MedPAC), the independent legislative branch agency tasked with analyzing the Medicare program for the purpose of offering insight and advice into the program for policymakers, published its annual Data Book.
The MedPAC Data Book, "Health Care Spending in the Medicare Program," is a...National News
Last Wednesday, Senate Majority Leader Chuck Schumer (D-N.Y.) announced a reconciliation package that includes drug pricing reforms, a three-year extension of the Affordable Care Act (ACA) tax credits enacted under the American Rescue Plan (ARP), in addition to deficit reduction and investments in climate and energy security. Senator Joe...Featured
Last week, the Centers for Medicare and Medicaid Services (CMS) released a Framework for Health Equity at CMS, a frequently-used term by the agency that has been mentioned in nearly every initiative of President Joe Biden's Department of Health and Human Services (HHS).
According to the CMS blog post "Establishing the Framework for...National News
Talks between Sen. Joe Manchin (D-W.Va.) and Senate Majority Leader Charles E. Schumer (D-N.Y.) laid the groundwork for a new drug pricing proposal that may be advanced during a budget reconciliation process; the proposal also includes a cap on annual out-of-pocket prescription drug costs for beneficiaries, limits the amount drug...CMS Rules
Earlier this year, President Joe Biden relaunched his Cancer Moonshot Initiative, which was initially established under the Obama administration to accelerate research into cancer prevention and cures. As part of the initiative, the Biden administration announced a new alternative payment model (APM) from the Center for Medicare and...National News
In addition to overturning Roe v. Wade and with it abortion access for millions of American women, the Supreme Court ended their term this year with a slew of other decisions that will carry new precedent for health industry legal cases going forward.
Last Friday, the high court announced an end to a years-long fight between the U.S....National News
This week in value-based care, a fresh look at untangling VBC for providers looking to enter into an ACO or payment model, results from the Comprehensive ESRD Care Model, and some market moves in long-term and home healthcare.
A new study published in Health Affairs on Monday demonstrates that the first Medicare accountable care...
Last Thursday, the Social Security and Medicare boards of trustees released their annual reports on each program and reported that the economic recovery was much stronger than anticipated following the COVID-19 pandemic. However, both programs will still face long-term concerns that could reduce retirement benefits and reduce...
Employer plans pay more than double the amount that Medicare pays for the same services, and a large number of Medicare beneficiaries continue to experience adverse events in hospital settings. On the policy side, the Congressional Budget Office has dashed the hopes of lowering the Medicare eligibility age to 60 and efforts to reform...National News
Value-based care is now a ubiquitous term across the medical industry, primarily led by Medicare payment models that prioritize quality of care above overall cost. But some are questioning the concept's utility and expanse over the Medicare market.
Legislation proposed in both the U.S. House of Representatives and Senate would...National News
This week, value-based care (VBC) is frequently seen as a method for primary care providers to best serve patients, but increasingly more facets of the healthcare industry are investigating how technology, data analytics and value-based insurance design can help swap volume for value and deliver results for their patients.
Hospitals...
Last Friday, April 22, 2022, the Centers for Medicare and Medicaid Services (CMS) issued a proposal to rectify a few of the issues many Americans face with Medicare enrollment.
The CMS press release says the proposed rule will implement provisions from the Consolidated Appropriations Act of 2021 and President Joe Biden's executive...
On Monday, the Centers for Medicare and Medicaid Services (CMS) published the Hospital Inpatient Prospective Payment (IPPS) and Long Term Care Hospitals (LTCH PPS) Proposed Rule, which will update Medicare fee-for-service payment rates and policies for inpatient hospitals and LTCHs for fiscal year 2023. The rule includes a 3.2% increase...
As COVID-19 restrictions relax and business practices return to normal guidelines, a large number of negligence and wrongful death suits have been filed due to a repeal of liability protections and statutory deadlines. Johnson & Johnson was unable to overturn a ruling in a deceptive marketing case regarding transvaginal mesh...
On Monday, the Centers for Medicare and Medicaid Services (CMS) filed the Fiscal Year 2023 Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Proposed Rule. The reimbursements include a 3.9% increase to industry reimbursements, but in aggregate the impact of payment policies would result in a decrease of $320 million in...National News
This week, the Center for Medicare hinted at new value-based approaches to palliative care; health equity takes precedence in the national conversation on rural payment models; and value-based contracts are analyzed for their ability to mitigate drug costs.
The Medicare Shared Savings Program (MSSP) is now ten years old, and with it...Arizona News
The White House is calling on Congress to act swiftly and pass another round of COVID-19 related funding, noting the consequences for testing, vaccination, boosters, monoclonal antibody treatments, surveillance and research in the fight against the coronavirus pandemic will be dire. This week, more than $5 million in Phase 4 Provider...National News
The Biden administration has pledged to provide Americans with better in-roads to health coverage and to even the playing field for people at a systemic disadvantage from receiving adequate healthcare. This week, a number of policy decisions highlight the administration's commitment to these goals in Medicare coverage, health equity and...National News
On February 24, the U.S. Department of Health and Human Services (HHS) announced that it would release an additional $560 million in Provider Relief Fund (PRF) payments for healthcare providers who have reported losses due to the COVID-19 pandemic. The funds will be released by the Health Resources and Services Administration (HRSA) and...
