Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Public Payers News

Merit-Based Incentive Payment System Transforms Meaningful Use

by

Last Spring, the Senate and the House of Representatives passed the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and repealed the former flawed SGR formula. Over the coming years, this law will require healthcare providers to...

Star Ratings System Created for Medicaid Home Health Services

by

Earlier this week, the Centers for Medicare & Medicaid Services (CMS) established a final rule that alters the Medicaid home health services definition to include additional requirements for home care services which expands beyond medical...

Medicare Spending May Increase $500 Billion over Next Decade

by

The Congressional Budget Office (CBO) has released information showing growing deficits that are expected to increase by more than $100 billion in 2016 and expand to $1 trillion by 2022. The Committee for a Responsible Federal Budget released...

Medicare-Medicaid Financial Alignment Shows Cost Savings

by

One program led by the Centers for Medicare & Medicaid Services (CMS) called the Medicare-Medicaid Financial Alignment Initiative moves toward improving the coordination and quality of healthcare services within Medicaid health homes while...

Medicaid Managed Care Spending Rose to $107 Billion in 2014

by

One area in which the federal government has put in excessive amounts of funds is the managed care arena. The reasoning may be due to the growing elderly population of baby boomers. The US Government Accountability Office released a report showing...

CMS, AMA Delve into Past and Future of Healthcare Market

by

Yesterday, representatives from the Centers for Medicare & Medicaid Services (CMS) and the American Medical Association came together to provide an overview of the current healthcare market in a presentation called “A Discussion with...

HHS Announces $157M for Accountable Health Communities Model

by

Earlier this week, the Department of Health and Human Services (HHS) announced new funds available of as much as $157 million to develop an Accountable Health Communities Model, which will show whether testing beneficiaries on social needs and...

Why State Medicaid Expansion May be Worthwhile for All

by

When the Supreme Court ruled that Medicaid expansion under the Patient Protection and Affordable Care Act is voluntary among the states, this set a precedence that allowed individual states to play partisan politics and withhold from financing...

The Impact of Medicare Advantage Plans, ACOs, Payment Reform

by

Now that the New Year is upon us, the Medicare program may be undergoing some significant changes that could affect patients and healthcare services. One ongoing transformative characteristic is the rise in enrollment in Medicare Advantage plans....

Medicaid Expansion Brought More Cancer Screenings among Women

by

Several years ago, the Supreme Court ruled that state Medicaid expansion under the Patient Protection and Affordable Care Act is to be optional for each region. This led a large number of states to forego expanding their Medicaid program for...

The History and Evolution of CHIP and the Medicare Program

by

When the medical industry including diagnostics and treatment became more complex and sophisticated in the early 1900s, everyday citizens began to see a surge in the costs for healthcare services. With more complicated procedures, treatment for...

Drug Spending Dashboard Shows Lack of CMS Negotiating Power

by

Last week, the Centers for Medicare & Medicaid Services (CMS) announced the release of an online dashboard that reports the amount of funds Medicare spends on prescription drugs. The drug spending dashboard covers both Part B and Part D programs,...

New Framework for MACRA’s Alternative Payment Models Released

by

Earlier this year, the federal government passed the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA), which reforms the Medicare program by abolishing the Sustainable Growth Rate (SGR) formula, developing a more effective value-based...

CMS Stresses Informed Decision-Making in Performance Reports

by

Since the Affordable Care Act was initially created, the Centers for Medicare & Medicaid Services (CMS) have been focused on improving informed decision-making among payers, providers, the patient community, and other stakeholders. CMS announced...

Physician Compare Website Upgrades Benefit Medicare Population

by

Medicare and Medicaid beneficiaries along with consumers of plans via state health insurance exchanges gained an advantage last week when the Centers for Medicare & Medicaid Services (CMS) announced website improvements to the Physician Compare...

Prescription Drug Spending Growth Skyrocketed 13% in 2014

by

In 2014, the rise of prescription drug spending hit 13 percent while overall healthcare spending growth increased by 5 percent. This steep rise is causing concern among both federal agencies like the Centers for Medicare & Medicaid Services...

Top 4 Policy Changes Affecting the Health Payer Market in 2015

by

The last year has had a huge impact on the health payer market as well as the entire healthcare industry from providers and educational institutions to the federal government and the patient community. Below we will outline the top four policy...

Vermont’s All-payer Model May Curb Rising Healthcare Costs

by

While healthcare reform has been taking place on a national level over the last several years, the state of Vermont is in the process of undergoing its own transformation within the medical industry through a new statewide all-payer model. The...

CMS Innovation Center’s Role in Improving Value-based Care

by

As healthcare payers and providers look toward adopting value-based care and move away from fee-for-service payment models, the Centers for Medicare & Medicaid Services (CMS) Innovation Center has been pursuing a variety of new healthcare...

How Value-Based Care Payment Models Could Reduce Costs

by

Did you know that 8 million people gained private insurance through the health insurance exchange and 3 million young adults gained coverage since the Affordable Care Act was passed? In recent years, the health insurance market and the medical...

Continue to site...