Primary Care First Model holds promise but faces challenges
CMS's Primary Care First Model aims to create incentives for primary care physicians to take on risk under value-based payment, but whether it will be successful remains to be seen.
Policy advisers urge continued Medicare ‘squeeze’ of hospital pay
Medicare can drive hospital productivity improvements and spending controls through more pay cuts, said policy advisers.
3 details for healthcare providers to know before taking on risk
Providers looking to take on downside ACO risk need to first understand three determinants of success.
Providers press CMS for details amid lingering uncertainty about new primary care models
The possibility of conflicts between Medicare payment models joined the customary concern about benchmarking details in provider feedback on coming primary care models, an administration official said.
CMS identifies keys to success in bundled payment as BPCI-A deadline looms
Ahead of next week’s deadline for providers to join the largest voluntary bundled payment program, the agency in charge of the program identified lessons learned from successful participants.
Four key takeaways from Congress’s latest single-payer hearing
Although the first hearing by a healthcare committee on recent coverage expansion proposals was supposed to encompass a range of Democratic bills, national single-payer proposals garnered almost all the attention.
Medicare Advantage plans accelerating their move into SDOH, advocate says
Medicare health plans have increasing authority to grapple with the social determinants of health, and more are pursuing such initiatives.
Why optimizing the patient experience should be on every C-suite leader’s radar
Jason Wolf, president and CEO of The Beryl Institute, knows from personal experience how easily a healthcare organization can lose a customer. A few years ago, his wife was mistakenly billed for a $25 copay that she already paid, and then the account was fast-tracked into collections. Despite receiving excellent clinical care, his wife vowed…
CMS cardiac procedure changes could cost hospital cardiac programs $700 million
In a move that could have profound financial implications for hospitals, the 2019 Outpatient Prospective Payment System final rule adds 17 cardiac procedures to the list of procedures approved by CMS to be performed in ambulatory surgery centers.
A caveat: A cardiac procedure performed in an ASC may cost a Medicare beneficiary more
For Medicare beneficiaries who are considering out-of-pocket costs for the cardiac services that CMS has approved to be performed in ambulatory surgery centers (ASCs), hospitals could be a more attractive site of service.