Payment Reimbursement and Managed Care

MedPAC report: Cost-based reimbursement isn’t an ideal way to sustain rural hospitals

An extensive healthcare policy report by the Medicare Payment and Advisory Commission includes a discussion about the drawbacks of cost-based Medicare reimbursement for rural hospitals.

Nick Hut June 16, 2021

CMS nearly doubles the payment rate for administering the COVID-19 vaccine in a Medicare beneficiary’s home

A payment increase for in-home COVID-19 vaccine administration is part of a strategy to improve vaccination rates, which have slowed in recent weeks.

Nick Hut June 10, 2021

Why fee-for-service can have a place in a reimagined healthcare system, but not as the primary mode of payment

Fee-for-service came under fire during a workshop in which prominent healthcare industry experts spoke of ways to achieve better integration of financing and care delivery.

Nick Hut June 9, 2021

Study quantifies the cost to physician practices of participating in the Merit-based Incentive Payment System

MIPS participation led to high administrative costs and a significant time drain, according to new research.

Nick Hut June 8, 2021

Survey data highlights shortcomings in private insurance coverage compared with Medicare

Indicators of coverage gaps were more likely to be seen among individuals with private insurance.

Nick Hut June 2, 2021

New CMS Administrator Chiquita Brooks-LaSure gets ready to tackle surprise billing, rural healthcare and much more

During her Senate confirmation hearing, Brooks-LaSure said strengthening Medicare, Medicaid and the Affordable Care Act to bolster quality and access while lowering costs will be paramount.

Nick Hut May 28, 2021

Democratic congressional leaders ramp up efforts to craft a health insurance public option, generating hospital pushback

Leading Democrats in the House and Senate sent out a request for information to healthcare stakeholders, seeking input as they look to establish a public option for health insurance.

Nick Hut May 26, 2021

CMS is curtailing voluntary participation in the Comprehensive Care for Joint Replacement bundled payment model

Hospitals that participated in the Comprehensive Care for Joint Replacement model on a voluntary basis over the last three years will be excluded after Sept. 30.

Nick Hut May 3, 2021

In a win for hospitals, CMS removes a rate-reporting requirement from the Medicare FY22 Inpatient Prospective Payment System

An FY22 requirement for hospitals to disclose privately negotiated MA rates on their Medicare cost reports has been rescinded in the proposed rule for the Inpatient Prospective Payment System.

Nick Hut April 29, 2021

Key payment details in the Medicare FY22 Inpatient Prospective Payment System proposed rule

CMS’s FY22 proposed rule for the Inpatient Prospective Payment System includes a 2.8% payment increase for general acute care hospitals.

Nick Hut April 28, 2021
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