Latest Headlines

Latest Headlines

Joint replacement prices, costs continue to vary widely

Billing data just released by the Medicare program has reinforced the wide disparity in what hospitals charge for their services--in this case, joint replacement surgery.

Physicians received $90 billion in 2013, CMS reveals

The Centers for Medicare & Medicaid Services paid approximately 3,900 physicians at least $1 million in 2013, according to a Bloomberg analysis of newly released data from CMS.

Unnecessary procedures drive cardiology fraud investigations

Westchester Medical Center's recent $18.8 million settlement resolving allegations of unnecessary cardiac procedures has raised patient safety concerns, along with questions about the potential for fraud and abuse among cardiology providers.  

Bundled payments may be more cost effective than ACOs

​A new report on the Medicare program's attempt to remake the nation's healthcare finance system praised accountable care organizations but also pushed for the continued use of bundled payments to facilitate lower-cost, higher-quality care.

GAO: Not enough transparency in how CMS values clinical work

The process for determining how much work a physician puts into completing a particular clinical task is often inflated and inaccurate, creating problems when Medicare and other federal agencies attempt to place an appropriate value on the task, according to a new report by the Government Accountability Office.

Do Medicare's financial penalties to improve care actually work?

The Medicare program has financially penalized hospitals for years for not preventing avoidable injuries to patients while they're hospitalized, but it is hard to determine whether that program has had a concrete impact.

Hospitals have improved productivity dramatically in recent years

Is it truly possible for hospitals to become more productive, providing patients with better care for less money? Apparently yes, according to recent research that examined productivity growth in U.S. hospitals that treated Medicare patients who had a heart attack, heart failure and pneumonia during 2002-2011.

Sixteen hospitals settle allegations of unnecessary outpatient psychotherapy for $15.7M

Sixteen hospitals across seven states have agreed to a $15.7 million settlement with the federal government to resolve claims that the providers improperly billed Medicare for Intensive Outpatient Psychotherapy, according to a Department of Justice statement.

Second-year Pioneer ACO results 'encouraging'

Accountable care organizations aligned with Medicare's Pioneer ACO program saw smaller increases in Medicare spending compared to general Medicare fee-for-service beneficiaries in the Pioneer program's second year, according to a study published in the  Journal of the American Medical Association.

MIPS or APM: Which is better for your practice?

Now that the Sustainable Growth Rate is no more, practices must choose one of two paths for reimbursement going forward.