Maryland Insurance Costs Rise Despite Hospital Price Controls
July 24—Despite a unique price control system for Maryland hospitals, insurers in the state’s Affordable Care Act (ACA) individual health insurance market have requested the largest average rate increase in the country.
Why Two Health Systems Opted Not to Launch Their Own MA Plans
July 23—After hospitals and health systems have had some highly publicized struggles operating their own Medicare Advantage (MA) plans in recent years, two health systems recently opted to partner on an MA plan with an insurer.
States Trying to Stabilize ACA Marketplaces
July 19—Amid growing policy uncertainty at the federal level, states are undertaking a range of responses to stabilize the individual-insurance marketplaces. But so far, the effect is uncertain.
July 23-27: Providers Examining Why APMs Are Expected to Stall
July 19—Provider organizations next week will continue their analysis of the recently issued massive Medicare physician payment proposed rule, including the surprise projection that alternative payment model (APM) participation may decline.
March Toward Value-Based Care Slipping: Survey
July 18—A new survey of physicians and health plan execs says the march toward value-based care is slipping, throwing shade on other surveys that say the transition to outcomes-based payment is on track.
Medicare Physician Pay Rule Targets Reporting Burden
July 17—Physician advocates are hailing a range of Medicare policy changes that were included in a recently proposed payment rule and are aimed at reducing clinicians’ administrative burden.
CMS Tweaks BPCI-A Time Frames
July 16—Some key timing parameters of the next large Medicare alternative payment model were changed in recent weeks.
What’s Driving Increased Hospital Cost Concerns?
July 13—The case for greater cost control at hospitals received its latest boost from a recent national survey of hospital executives. The growing urgency comes amid shrinking margins and cash flow.
July 16-20: Congress to Examine Stark Law Modifications; Verma Pledges Changes
July 12—As Congress gears up to examine statutory changes to the Stark Law next week, the Trump administration is planning to implement changes on an administrative basis.
Congress Pushes 340B Bills to Cut Eligibility, Increase Reporting
July 11—Members of Congress this week pushed emerging legislation to restrict the ability of hospitals and other providers to qualify for the 340B discount drug program and to increase their reporting requirements.