Latest Headlines

Latest Headlines

CMS increases Medicare Advantage payments, reverses February proposal

Health insurers operating Medicare Advantage plans can expect revenue to increase 1.25 percent next year, the Centers for Medicare & Medicaid Services  announced Monday. However, insurers likely will see their overall revenue increase about 3.25 percent as they deliver and bill for more intense services.

Two-midnight rule delayed again

The Centers for Medicare & Medicaid Services once again delayed implementation of the two-midnight rule.

Socioeconomic hardships hurt dual eligibles' health outcomes

Sociodemographic factors are a major driver of adverse health outcomes for patients who qualify for both Medicare and Medicaid, or "dual eligibles," according to a new study from healthcare analytics firm Inovalon.

Seniors love Medicare Advantage

Most seniors are satisfied with their Medicare Advantage coverage and costs, according to a new poll from Morning Consult. The findings help bolster the insurance industry's case against the Obama administration's most recent proposal to decrease Medicare Advantage payment rates.

SGR repeal likely, but not a cure-all for physician challenges

Although physician groups criticized legislators for taking recess before voting on a proposed repeal of the Sustainable Growth Rate (SGR) formula, chances are good that the Senate will follow the House's lead and approve HR 1470 within the next two weeks,  Medical Economics  reported.

Mobile care management program helps ACO slash readmissions

A California accountable care organization is seeing lower number of hospital readmissions of high-risk patients thanks to a two-year mobile care management project.

Why healthcare providers can't back down on SGR repeal

While there is no guarantee it will pass, there is hope that lawmakers' latest proposal to repeal the Sustainable Growth Rate formula will succeed. As with past attempts to do away with the formula, the $210 billion price tag, only $70 billion of which would be offset, is the key hurdle that may prevent Congress from passing the legislation, according to  FierceHealthFinance.

Appeals court invalidates CMS contract with RACs

It may be back to square one in the Centers for Medicare & Medicaid Services' bid to create new pacts with recovery audit contractors. The U.S. Court of Federal Appeals has invalidated the current proposed contract with RACs, primarily due to their violation of U.S. acquisition regulations

AHA supports bill to repeal Independent Payment Advisory Board

The Independent Payment Advisory Boardmay be one of the most obscure yet unpopular components of the Affordable Care Act. And the nation's hospital sector has added its voice to those against the IPAB,  AHA News Now  has reported.

Alternative quality care contracts can be 'backbone' for payment reform

The alternative quality care contract that Blue Cross Blue Shield of Massachusetts has had in place since 2009 could serve as a payment reform "backbone" for other insurers as they increasingly reward quality, efficient care, according to a new report from Avalere Health.