Short-term plans have little adverse effect on insurance market: study
Although a federal boost to short-term insurance plans raised alarm among hospital advocates, early evidence suggests there has been little adverse impact on the individual insurance market.
CMS Overhauls the Medicare Shared Savings Program
CMS’s Pathways to Success final rule is a challenging proposition for ACOs participating in the Medicare Shared Savings Program (MSSP).
HOPDs vs. ASC: Understanding Payment Differences
The growth of ambulatory surgery centers has hospitals and health systems looking at payment in a new way.
States reeling under rising healthcare costs
Rising Medicaid costs and high costs of healthcare for state employees are having a negative effect on state budgets.
Montana’s dive into Medicare reference pricing reduces provider payments by almost $16 million annually
Montana’s adoption of Medicare reference pricing has dramatically reduced payment rates for healthcare services delivered to state employees.
Analysis: CMMI primary care initiatives: Potential opportunity but lots of questions
The five new alternative payment models offer multiple participation options for primary care practices of different sizes with advanced capabilities.
Characteristics of high-performing ACOs
High-performing accountable care organizations (ACOs) have five characteristics in common that help them achieve success with value-based payment contracting.
Summary checklist for assessing readiness for value-based care
Healthcare finance leaders should use a checklist to assess their readiness to pursue value-based contracting.
A timeline guide to developing an ACO/CIN
Healthcare organizations seeking to establish a an accountable care organization (ACO) or clinically integrated network (CIN) should allow for an eight-year, five-phase process
Deceased Medicare beneficiary admissions: Accounting for the causes and impacts
Just over 3 percent of Medicare admissions end with the death of the patient. This finding is based on data from fiscal years 2015 through 2017 reported in the Medicare Provider Analysis and Review (MedPAR) file. As would be expected, the time and resources required to treat a beneficiary who is near death and ultimately…