CMMI’s “New Direction” Comments Indicate Enthusiasm of Healthcare Stakeholders
Dave Terry describes how feedback to a CMS announcement last fall has spurred another request.
How MA Plans Are Changing VBID Approaches
May 18—Medicare Advantage (MA) plans are evolving their approaches in the expanding Medicare pilot for value-based insurance design (VBID).
Methodology Used to Identify Top Procedures Performed at Hospitals and Free-Standing Clinics
Recent research on hospital versus free-standing facility pricing used 2016 Medicare hospital OPPS data as its basis.
A Look at Two Blues’ Distinct Approaches to Changing the Healthcare Model
May 16—Two dominant not-for-profit health plans—both Blue Cross insurers—are moving aggressively in very different directions.
Decoding MSPB: Trending Better Faster
Dale Schumacher and Fern Nerhood describe how trends in Medicare spending per beneficiary can affect hospital finances.
340B Targeted in Trump Administration Drug Push
May 15—Hospital advocates and others raised concerns about impacts of the Trump administration’s recently announced initiative to address rapidly rising drug prices in part through policy changes to an existing drug discount program.
FY2019 Skilled Nursing Facility Proposed Rule Summary
This document summarizes the FY2019 proposed rule updating the skilled nursing facility (SNF) payment rates.
Former CMS Leaders: ACO Changes Are Coming
May 11—Medicare accountable care organizations (ACOs) are likely to face an imminent overhaul, according to former leaders of the program.
Competing with Freestanding Outpatient Centers—Where to Focus on Pricing
Price reductions should be included in pricing strategies to help hospitals better compete with these free-standing centers.
May 14-18: Senate Holds 340B Hearing Amid Surge in Activity
May 10—Congress will once again examine the 340B discount drug program next week amid several judicial and regulatory developments related to the program.