Value: The Way Forward
Value-based payment won’t bend the cost curve unless healthcare organizations commit to fundamental change. Not everyone will come out whole.
The Current Outlook for Value-Based Care Under the Trump Administration
Value initiatives introduced by the Affordable Care Act have met with varied success. Under the Trump administration, the future of these initiatives is uncertain.
Latest ACO Trends Identified
April 20—Although private accountable care organizations (ACOs) appear to be gaining ground, the Medicare versions are still leading—amid challenges.
New MA Rules Benefit Provider-Sponsored Plans
April 18—Recently announced Medicare Advantage (MA) rates and rule changes could help sometimes-struggling provider-sponsored plans improve their performance.
Ask the Experts: Cost Sharing Programs
I am looking for more information about how to manage patients covered by cost sharing programs.
Confirming Eligibility of ACA Medicaid Enrollees ‘Top Priority’ of Administration
April 13—Amid a recent finding that three states spent more than $1 billion on enrolling ineligible Medicaid beneficiaries, the Trump administration is prioritizing the verification of eligibility among the 11 million who were added to the Medicaid rolls through healthcare reform.
Ask the Experts: CJR Physician Gain Sharing Agreements
Are boilerplate CJR physician gain sharing agreement templates available or should agreements be created from scratch?
Are ACOs Saving Medicare Money?
April 10—Whether accountable care organizations (ACOs) save money for Medicare has emerged as a key question because it could determine how hard regulators push participating providers to take on downside risk.
Can Maryland Hospital Price-Setting Serve as a National Model?
April 10—Hospitals may have reasons to support a shift to a global budget model like the one used in Maryland, some healthcare policy leaders say.
Medicaid Waivers: Work Requirements Are Not the Only Changes Coming
Work requirements present unknown changes and impacts, but the impact may not be as big as some assume. However, what providers and recipients need to consider are the other and seemingly less significant changes that will intensify the overall impact of an 1115 Medicaid demonstration waiver.