By Jordan Rau – The federal government paid bonuses to 231 hospitals with subpar quality because their patients tend to be less expensive for Medicare, new research shows. The bonuses are small, generally a fraction of a percent of their Medicare payments. Nonetheless, rewarding hospitals of mediocre quality was hardly the stated goal…
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By Karen B. DeSalvo MD & Andy Slavitt – Seven years ago, Congress passed a law to spur the country to digitize the health care experience for Americans and connect doctor’s practices and hospitals, thereby modernizing patient care through the Electronic Health Records (EHRs) Incentive Programs, also known as “Meaningful Use.”
By Mary Agnes Carey – As the health law turned six, federal officials proposed the expansion of a Medicare diabetes prevention program funded by the landmark measure. The pilot program, developed and administered by the YMCA…
By Patrick Conway – The launch of the Comprehensive Care for Joint Replacement Model (CJR) on April 1 is a major step toward transforming care delivery in Medicare. Why? Because this model looks to improve care and quality for the most common procedures that Medicare beneficiaries have, hip and knee replacements.
By Johanna Legaspi – Hierarchical Condition Categories were mandated in 1997 by CMS and have been the basis for reimbursement for Medicare Advantage plans since 2004. HCCs use data to prospectively estimate predicted costs for enrolled members during the next year of coverage.
By Phil Galewitz – She didn’t want to spend the rest of her days seeing doctors, the 91-year-old woman confessed to Dr. Kevin Newfield as he treated a deep wound on her arm. “You don’t have to, but you have to tell me what you do want,” Newfield replied. “I’m not afraid of dying. I’m afraid of being 106,” she told the surgeon and her daughter, who was in the room with them.
By Julie Appleby – Medicare plans to test new ways to pay for prescription medications given in doctors’ offices and hospital outpatient centers — moves likely to win praise from some policy experts, but opposition from facilities and practitioners.
The Centers for Medicare & Medicaid Services (CMS) released proposed changes for the Medicare Advantage and Part D Prescription Drug Programs in 2017 that will, if finalized, provide stable and fair payments to plans, and makes unprecedented improvements to the program for plans that provide high quality care to the most vulnerable enrollees.
By Shefali Luthra – A growing number of primary care doctors, spurred by the federal health law and frustrations with insurance requirements, are bringing a service that generally has been considered “health care for billionaires” to middle-income, Medicaid and Medicare populations.