Data Sharing Tips for Value-Based Payment Arrangements
Value-based contracts require that provider organizations and health plans share data and information that they may not have shared historically. Details about that data-sharing must be established in contracts.
The Time Is Now to Act on the 2019 Medicare Final OPPS Rule
Although some OPPS rule changes are being challenged by key stakeholders, hospitals and health systems should move forward with implementation and measure the financial impact.
New Healthcare Partnerships and Technology Bring Real Competition to Health Systems
Robert P. Chamberlain discusses the move toward employer-offered health care and how health systems can compete.
Feb 4-8: CMS Developing ESRD, Cancer Models
Jan. 31—Federal changes coming in 2019 to healthcare payment models slowly emerged this week, as federal healthcare leaders prepare to address a national policy meeting in Washington D.C.
Provider Payments Among Drug Costs Targeted by Congress
Jan. 29—Two provider payment systems were highlighted by members of Congress this week as areas in which policy changes are needed to control drug costs.
HHS Notice of Benefit and Payment Parameters for 2020 Proposed Rule Summary
Summary of the Notice of Benefit and Payment Parameters for 2020 proposed rule, published by CMS.
Medicare Physician Fee Schedule Final Rule: 3 Must-Do Steps for Physicians
The Medicare Physician Fee Schedule for 2019 includes a variety of new policies—and revenue opportunities for providers if they take a few key steps in relation to areas such as payment rates, documentation requirements, and new services.
Medicare Expands Value Pay in MA and Part D Plans
Jan. 21—Medicare is expanding its value-based insurance design (VBID) model and creating a new drug plan model.
CAHs and Cost Reports
A critical access hospital’s cost of delivering care to Medicare patients is estimated using the cost accounting data that these Medicare-certified institutions submit annually to CMS via Medicare cost reports.
The Texas Federal District Court’s Ruling on the Constitutionality of the ACA
The 2018 ruling in by the Texas District Court declaring Affordable Care Act unconstitutional is expected to be overturned, but the decision still could have an adverse effect on the future of value-based payment.