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.
MedPAC Recommends $250 Million ED Cut
April 9—Medicare should cut payment rates for many emergency departments (EDs) by 30 percent, Congress’s leading Medicare advisory panel recommended this week.
Ask the Experts: Medicare Small Balance Payments
Is there any concern if copayment under a certain amount are written off?
Contracting for Primary Care and Value Improves Patient Outcomes and Lowers Costs
Humana offers primary care practices four types of value-based contracts, but also customizes plans that emphasize population health or other initiatives.
FFS Medicaid Most Challenging for Billing: Study
April 4—One of the first direct comparisons of billing complexities between various types of payers found that Medicaid fee-for-service (FFS) programs were the most challenging for providers.