States reeling under rising healthcare costs
Rising Medicaid costs and high costs of healthcare for state employees are having a negative effect on state budgets.
Montana’s dive into Medicare reference pricing reduces provider payments by almost $16 million annually
Montana’s adoption of Medicare reference pricing has dramatically reduced payment rates for healthcare services delivered to state employees.
Analysis: CMMI primary care initiatives: Potential opportunity but lots of questions
The five new alternative payment models offer multiple participation options for primary care practices of different sizes with advanced capabilities.
Characteristics of high-performing ACOs
High-performing accountable care organizations (ACOs) have five characteristics in common that help them achieve success with value-based payment contracting.
Summary checklist for assessing readiness for value-based care
Healthcare finance leaders should use a checklist to assess their readiness to pursue value-based contracting.
A timeline guide to developing an ACO/CIN
Healthcare organizations seeking to establish a an accountable care organization (ACO) or clinically integrated network (CIN) should allow for an eight-year, five-phase process
Deceased Medicare beneficiary admissions: Accounting for the causes and impacts
Just over 3 percent of Medicare admissions end with the death of the patient. This finding is based on data from fiscal years 2015 through 2017 reported in the Medicare Provider Analysis and Review (MedPAR) file. As would be expected, the time and resources required to treat a beneficiary who is near death and ultimately…
Provider nimbleness required for diverse value-based healthcare models
Many providers are in the throes of implementing strategies for value-based health care. But now they must adapt to an environment characterized by diverse value-based care models, new players, and more data to discern provider value. To weather the next decade, the key attribute providers will need is nimbleness—a challenge in an industry not known…
Analysis: Comparing commercial hospital rates to Medicare is inappropriate
RAND study says hospitals treating patients with private health insurance were paid 2.4-times the Medicare rates, but Chad Mulvany says Medicare is the wrong measuring stick.
Medicare buy-in option beginning at 55 the most likely expansion route, says former CMS chief
If everything goes right for Democrats in the 2020 election, the most likely Medicare expansions are not the ones getting the headlines now, says a former Medicare administrator.