Latest Headlines

Latest Headlines

Fee-for-service payments incentivize unnecessary cardiac surgeries

Lucrative reimbursement for cardiac procedures in Medicare's fee-for-service model is at the heart of an investigation involving three Indiana surgeons accused of performing unnecessary surgeries on hundreds of patients while the hospital turned a blind eye, according to  The New York Times.  

Medicare prescription costs to increase significantly in 2016

Medicare beneficiaries will pay an average of 13 percent more on their medications in 2016, the largest increase since 2009, according to a new Kaiser Family Foundation brief.  

Is a new ACO payment model on the way?

A new global-risk adjusted model may be more appropriate for accountable care organizations, experts argued in a  Health Affairs  blog  post

Hospital payments for outpatient services rise faster compared to ASCs

The prices for procedures at hospital outpatient departments have increased in recent years at a much higher rate than ambulatory surgical centers, according to a study published in  Health Affairs.

High-cost seniors turn to traditional Medicare over Medicare Advantage plans

Many seniors switch from Medicare Advantage plans to traditional Medicare when they become seriously ill, which raises questions about how well MA plans can serve this population of high-cost patients, according to a new  Health Affairs  study.

Senate hearing addresses Medicare and Medicaid overpayments

The federal government spent an estimated $124.7 billion in 2014 inimproper payments across 22 government agencies, most of which came from Medicare and Medicaid programs, according to expert testimony from a senior GAO official.  

Aging population poses threats and opportunities to practices

The U.S. population is aging, making Medicare beneficiaries an increasingly prevalent part of practices' patient panels. This trend poses both challenges and opportunities for all medical providers.

Membership models appeal to nearly half of PCPs, survey finds

Citing frustrations with third-party payers and inadequate time to spend with patients, nearly half (46 percent) of primary care physicians who participated in a recent survey said they would consider transitioning to direct pay, concierge or other membership models in the next three years.  

Another chronic care management challenge: Achieving ROI

More than two-thirds of Medicare beneficiaries suffer from two or more chronic conditions, which often require more time and resources to manage than most physicians say they have, according to a new report from SmartCCM.

Report: To keep Medicare spending in check, promote price sensitivity

With Medicare spending on the rise, policymakers should work to promote price sensitivity among beneficiaries long after they've met their deductibles,  according to the National Center for Policy Analysis.