A new report from the Medicare Payment Advisory Committee (MedPAC) demonstrates that Medicare Advantage expansion is having a negative effect on hospital finances as MA-related revenue is lower than that of fee-for-services.
The MedPAC report reviewed claims data for 24 million beneficiaries enrolled in both MA and FFS and found that...
MedPAC is concerned about the adequacy of fee-for-service (FFS) Medicare rates and the sunsetting of participation bonuses for clinicians in advanced alternative payment models (A-APMS). Commissioners also discussed the Medicare Advantage PA problem, considered how to lower FFS rates for inpatient rehabilitation facilities and much more...
Last Friday, the Medicare Payment Advisory Committee (MedPAC) sent its recommendations to Congress, including updates for the 2025 Medicare payment systems. In its recommendations, the committee warned that Medicare Advantage policies are increasingly costly to the Medicare program.
At the top, it recommended a 1.5% raise for hospital...National News
The Medicare Payment Advisory Committee (MedPAC) met last Thursday to discuss recommendations for Medicare-related payment rates as Congress and the Centers for Medicare and Medicaid Services (CMS) gear up to address industry reimbursement in 2025.
The committee recommended raises for the hospitals and physicians but wants lower base...National News
Another new year, another report from the Medicare Payment Advisory Commission (MedPAC) saying that Medicare Advantage is more expensive in exchange for lower quality coverage.
This year, the commission found that the federal government will pay Medicare Advantage (MA) insurers $88 billion more than it would if their share of...National News
The Medicare Payment Advisory Committee (MedPAC) published its draft recommendations for Medicare's fee-for-service payment policies and largely renewed its call to substantially limit pay boosts for physicians, hospitals and nursing homes.
The draft recommendation includes a recommendation to give physicians a 1.3% pay increase in...
As the nursing home industry pushes back on the Biden administration's proposal for mandatory federal staffing minimums, a new study suggests the U.S. may want to pivot away from recruitment and towards staffing retention in order to stabilize staffing rates.
Last month, Medicare proposed a new rule that would require long-term care...
The Medicare Payment Advisory Committee (MedPAC) released its 2023 summer data book on spending for the Medicare program. The report includes data across the program including demographics, access to care, quality of care metrics, dual-eligibility data, alternative payment models, and prescription drugs.
The Medicare program was the...CMS Rules
The Centers for Medicare and Medicaid Services (CMS published its proposed physician fee schedule (PFS), which add up to a 1.25% decrease in pay for Medicare physicians for 2024. Physician groups and industry leaders met the news with frustration, with some doubling down on calls to reform the entire payment formula. CMS also posted the...
Congress is moving to address glaring payment issues for the Medicare program; some lawmakers have mobilized by taking aim at the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
For years, there has been an ongoing battle between the Medicare program and physicians who bill the program for payment. Too many options...
The Medicare Payment Advisory Commission (MedPAC) published its annual June Report to Congress, which includes suggestions to unify payment methodologies for post-acute care, address issues within Medicare Advantage, and lower telehealth payments.
The MedPAC recommendations for streamlining payment methodologies for skilled nursing...
A new study by University of Southern California (USC) Leonard D. Schaeffer Center for Health Policy and Economics estimates that overpayments to Medicare Advantage plans could exceed $75 billion annually or 20% of total payments.
The report doubles overpayment estimates made by the Medicare Payment Advisory Commission (MedPAC), which...
The Centers for Medicare and Medicaid Services (CMS) published the FY 2024 Inpatient Prospective Payment System (IPPS) and Long-term Care Hospital Prospective Payment System (LTCH PPS) rule updates. The rule includes a 2.8% raise in operating payments for acute care hospitals.
The proposed rule updates Medicare payments and policies...
The Medicare Payment Advisory Committee (MedPAC) submitted its
March 2023 Report to Congress which included its 2024 payment recommendations for Medicare fee-for-service (FFS), Medicare Advantage (MA) and the Medicare prescription drug program (Part D). This year's report is likely to please no one as the committee took aim at claims of...
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...
The Medicaid and CHIP Payment and Access Commission (MACPAC) and the Medicare Payment Advisory Commission (MedPAC) released its 2023 data book on dually eligible beneficiaries this week.
Dual-eligible beneficiaries receive Medicare as the primary payer, which covers medical services including physician, inpatient and outpatient care....National News
Last week, the Medicare Payment Advisory Commission (MedPAC) made its recommendations to Congress for Medicare payment rates for hospitals and physicians.
Commissioners made it known that the recommendations were a reflection of the current environment and issues related to the COVID-19 pandemic, but didn't recommend to raise rates...National News
As the national mental health crisis worsens, in part due the COVID-19 pandemic for patients and healthcare workers alike, behavioral healthcare integration is at the top of industry priorities. This week, health care payers of all stripes are innovating solutions to covering costs.
The Medicare Payment Advisory Commission (MedPAC)...National News
Last Friday, the Medicare Payment Advisory Committee (MedPAC) held a public virtual meeting to assess payments for hospice services and make recommendations for updating payments. It determined that it would recommend a 3% cut to Medicare base payments made to skilled nursing facilities (SNFs) in 2024.
The meeting presages the...
Last Thursday, the Kaiser Family Foundation (KFF) published a report demonstrating that Medicare Advantage is poised to represent over half of Medicare beneficiaries as soon as next year. Another report, published simultaneously, showed that over $10 billion has been spent by Medicare on the quality bonus program (QBP) that incentivizes...
