Home Is Where the Hospital Is
The hospital-at-home model provides a potential means of reducing total costs of care and improving outcomes, but it would present traditional acute care hospitals with a strategic challenge.
Health System-Owned Physician Practices: Are Any Losses Acceptable?
Health systems that own physician practices should fully address losses those practices incur and take steps to remediate the issues underlying those losses.
Medicare Advantage for More: A Pragmatic Alternative to Medicare for All
An expansion of Medicare Advantage presents an opportunity for the U.S. to test the waters of a single-payer system.
July 30-Aug. 3: As CMS Offers MIPS Review, Physicians Urge Its Preservation
July 26—Members of Congress and some physician leaders urged the continuation of Medicare’s Merit-based Incentive Payment System amid growing calls for its elimination. However, many agreed the system needs changes.
Public Poll, Verma Reject Single-Payer
July 25—The administrator for the Centers for Medicare & Medicaid Services (CMS) said she is likely to reject an expected single-payer proposal from California. Her position echoed the sentiments of a national poll released this week.
CY2019 Medicare End-Stage Renal Disease (ESRD) Prospective Payment System Proposed Rule: HFMA Executive Summary
CMS published a proposed rule updating payment rates under the Medicare End-Stage Renal Disease prospective payment system for CY2019, in the July 19, 2018, Federal Register.
Maryland Insurance Costs Rise Despite Hospital Price Controls
July 24—Despite a unique price control system for Maryland hospitals, insurers in the state’s Affordable Care Act (ACA) individual health insurance market have requested the largest average rate increase in the country.
Why Two Health Systems Opted Not to Launch Their Own MA Plans
July 23—After hospitals and health systems have had some highly publicized struggles operating their own Medicare Advantage (MA) plans in recent years, two health systems recently opted to partner on an MA plan with an insurer.
States Trying to Stabilize ACA Marketplaces
July 19—Amid growing policy uncertainty at the federal level, states are undertaking a range of responses to stabilize the individual-insurance marketplaces. But so far, the effect is uncertain.
July 23-27: Providers Examining Why APMs Are Expected to Stall
July 19—Provider organizations next week will continue their analysis of the recently issued massive Medicare physician payment proposed rule, including the surprise projection that alternative payment model (APM) participation may decline.