Dual Eligible Programs Show Mixed Results
The Affordable Care Act-inspired effort to find more effective ways to serve the so-called dual eligible population – mostly the disabled and low-income elderly covered by both Medicare and Medicaid – is not providing the kind of results policy-makers expected [...]
Finance Committee Advances Chronic Care Proposals
The Senate Finance Committee’s chronic care working group has issued a policy options document presenting more than 20 proposals for improving how Medicare serves beneficiaries with chronic medical conditions. The document is the product of a bipartisan work group. The [...]
GAO Calls for Look at Medicare Outpatient Payments
Citing the growing consolidation of hospitals and physician practices and the higher rates Medicare pays for care delivered in hospital outpatient departments, the U.S. Government Accountability Office (GAO) has recommended that Congress …consider directing the Secretary of the Department of [...]
MedPAC Recommends Socio-Economic Risk Adjustment of Medicare Advantage Star Ratings
The agency that advises Congress on Medicare payment issues has suggested to the Centers for Medicare & Medicaid Services (CMS) that it revise its star ratings systems for Medicare Advantage plans. In a letter to CMS in response to its [...]
MedPAC Meets, Discusses Payment Issues
Last week the commissioners serving on the Medicare Payment Advisory Commission (MedPAC) met in Washington, D.C. to discuss the group’s future recommendations to Congress. While MedPAC’s recommendations are not binding on Congress or the administration, they are highly respected and [...]
MedPAC Addresses Major Issues for Private Safety-Net Hospitals
The independent federal agency that advises Congress on Medicare payment issues discussed several issues of great importance to private safety-net hospitals at its December 10 meeting in Washington, D.C. During the course of a discussion about FY 2017 Medicare inpatient [...]
Source Materials on Medicaid
The National Association of Medicaid Directors recently held its 2015 fall conference. The following are presentations made at the conference by state and federal Medicaid officials, consultants, foundation officials, associations, non-profit groups, and others. A Medicaid Approach to Evaluation – [...]
Primary Care Docs Face Medicare Pay Cuts
Primary care physicians will see their Medicare reimbursement decline next year when a program that pays them a 10 percent bonus expires. The program, launched in 2011 to help close the gap between private insurance and Medicare primary care payments, [...]
Medicare’s Bundled Payments Challenge
Now that the U.S. Department of Health and Human Services has set a target of making 50 percent of all Medicare payments through alternative payment systems by the end of 2018, one of those alternative systems, known as “bundled payments,” [...]
Push From Volume to Value Continues
As the end of 2015 nears, CMS has used its blog to reflect on its continued efforts to move the U.S. health care system from one that pays for the volume of care provided to one that pays for the [...]
