CATEGORY
CMS Direct Contracting is coming fast, is very nuanced, and full of grey. In a nutshell, 50% of Medicare patients are in Medicare Advantage (i.e., value-based care) and 50% are still Medicare…
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The pandemic has had a tremendous impact on the business of healthcare. With states canceling elective procedures and people deferring care for fear of being exposed to the virus, hospital and medical…
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Health systems have been working hard to lay the foundation for taking on a larger case mix of value-based contracts. 75% of health systems surveyed said they are ready to accept downside risk in the next two…
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The CMS NPRM (Notice of Proposed Rule Making) is much more interesting than many of the past interop-related rules. That's because it gets specific. It gets specific about technology by calling out FHIR APIs.…
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CMS completed the first of three planned reviews of health plan Provider Directory Accuracy and the results were not good. A few stats jump out: Nearly half of provider directory locations listed were…
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A few months back this story caught my eye: Insurers, hospitals clash over help paying ACA plan premiums . It describes an issue where insurers believe that hospitals are steering patients who are eligible…
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On this episode of The #hcbiz Show! we talk with Roger A. Maduro and David Perara of Open Health News about the $7.5 Billion/yr Medicaid Open Health IT initiative. The state-based Medicaid Management…
Continue Reading →Join us on Wednesday, December, 7 at 12 PM EST for a panel discussion on CMS' $5 Billion per year Open Medicaid IT strategy. CMS wants to move away from long-running, highly expensive, single-vendor projects…
Continue Reading →On this episode of The #hcbiz Show! Don Lee and Shahid Shah interview CMS spokesperson Aisling McDonough . We discuss the MACRA final rule and the resources that CMS is making available to help clinicians…
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CMS released the MACRA final rule last week and the industry response seems positive so far. They made good on their promise to consider stakeholder feedback and they addressed many of the concerns that were…
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Medicaid is a big part of our national healthcare expenditure. It accounts for 25% of the average state budget and nearly 10% of the federal budget . Caring for the 72 million+ Medicaid enrolled…
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The deadline for public comment on the MACRA proposed rule is June 27, 2016 at 11:59 PM ET. This is the most comprehensive healthcare legislation enacted since Obamacare (ACA) and it will have a significant…
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On April 27, 2016, the Department of Health and Human Services issued a Notice Executive of Proposed Rulemaking to implement key provisions of the Medicare Access and Summary CHIP Reauthorization Act of 2015…
Continue Reading →Before an ACO can share in any savings generated, it must demonstrate that it met the quality performance standard for that year . Quality Reporting can be an intimidating process for new or prospective…
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