Transparency, Interoperability, DSH Changes Lead Hospital IPPS Concerns
July 6—Hospital advocates recently raised a range of concerns about proposed Medicare payment policy changes, including transparency and interoperability requirements and a new way to calculate uncompensated care payments.
Pilot to Offer APM Bonuses to Physicians in Medicare Advantage
July 3—Medicare plans to launch a pilot—as soon as this year—to allow physicians paid through Medicare Advantage value-based arrangements to qualify for the same bonuses as those working in advanced alternative payment models.
Definition of “Employer” under Section 3(5) of ERISA – Association Health Plans Final Rule Executive Summary
This document summarizes the Employee Benefits Security Administration's Association Health Plans final rule, published in the June 21, 2018, Federal Register.
Who’s Afraid of a Little Risk?
The Medicare ACO modeled advanced by CMS has encountered some challenges, but it still holds promise if CMS addresses the flawed idea of retrospective attribution of patients to an ACO.
Physician Distribution, Mobility, Fair Market Value and Compensation Surveys
An analysis of regional differences in physician compensation coupled with the general tendency against long-distance relocation shows there is no truly national market for established physicians. Rather, local market conditions must be considered in setting fair market value.
HFMA Comments on FY2019 IPPS Proposed Rule
HFMA submitted comments to the Centers for Medicare & Medicaid Services (CMS) on the FY2019 IPPS proposed rule published in the May 7, 2018, Federal Register.
Trump Administration to Replace Value-Based Payment Goal
June 20—Department of Health and Human Services (HHS) Secretary Alex Azar II has rejected the Obama administration’s goal of shifting 50 percent of Medicare payments to value-based payment models by the end of 2018.
Health Plans, Providers Collaborate on Payment Transformation in Hawaii
More than 500 primary care providers have moved to per-member, per-month payments for patients covered by Hawaii’s largest health plan. The initiative may provide a roadmap for smaller physician practices to participate and flourish in the transition to value.
Rejecting Hospital Concerns, Administration Expands Association Plans
June 19—Despite calls from major hospital groups to drop a proposed expansion of association health plans (AHPs), the Trump administration has finalized those rules.
Prospective Bundles, Downside Risk Models Trending: Survey
June 18—The prevalence of prospective bundled payment and downside risk among payment models offered by private health insurers surprised a sponsor of a new national survey.