Medicare Payment and Reimbursement

Survey: Health systems push toward risk-based payment models, payer-provider partnerships

Check out the key takeaways from a survey conducted in Summer 2021 with healthcare executives, which focused on risk-based models, data issues, leaders’ concerns on hitting budgets and more.

Crystal Milazzo January 28, 2022

Hospitals need federal support to handle the ongoing staffing and financial crunch, industry leaders say

The hospital industry issued its latest plea for additional federal help to mitigate the financial and operational strain of COVID-19, including surging staffing costs.

Nick Hut January 26, 2022

The COVID-19 vaccine mandate for healthcare workers can take effect nationwide, Supreme Court says

The court lifted injunctions that had halted implementation of the COVID-19 vaccine mandate in half the country, leaving hospitals and other affected providers with likely only a few weeks to begin complying.

Nick Hut January 21, 2022

Coverage denials based on medical necessity are far more likely to arise from Medicare FFS rules than from MA plan policies

Coverage rules stemming from Medicare national and local determinations were the most likely cause of claim denials in one Medicare Advantage plan.

Nick Hut January 18, 2022

CMS proposes to restrict Medicare coverage of a high-profile new Alzheimer’s drug

Medicare will pay for use of a new drug to treat Alzheimer’s disease only for patients in approved clinical trials, CMS said in a proposed coverage determination.

Nick Hut January 12, 2022

CMS now says hospitals in half the country must abide by the COVID-19 vaccine mandate starting in late January

The status of the COVID-19 vaccine mandate for healthcare workers took another twist, with CMS stating it will look to enforce the mandate within a month in 25 states and Washington, D.C.

Nick Hut January 1, 2022

A White House plan to combat the omicron variant includes support for hospitals

The Biden administration announced several provisions to bolster hospitals as efforts to contain the COVID-19 pandemic enter a third calendar year.

Nick Hut December 22, 2021

A bill to mitigate scheduled Medicare payment cuts of $14 billion is ready to go in Congress

The House of Representatives is set to vote on a bill that would nullify a large share of 2022 Medicare payment cuts.

Nick Hut December 9, 2021

Hospital-at-home care promises to reshape healthcare delivery in the United States

Two leaders of health system hospital-at-home programs describe how the acute hospital care at home model represents an important change in how our nation approaches healthcare delivery, because it has been shown to yield improved care outcomes and greater patient satisfaction.

Eric C. Reese, PhD December 9, 2021

Healthcare industry leaders share ideas with CMMI for improving value-based payment models, with benchmarking a top concern

During a recent call with healthcare stakeholders, leaders with the Center for Medicare & Medicaid Innovation heard various ideas for improving value-based payment models.

Nick Hut December 4, 2021
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