Reimbursement
The data shows a trend toward comprehensive benefits and significant cost savings, though concerns remain, especially regarding consumer protections.
Use of AI led to cost reductions including a 25 percent drop in hospital length of stay and 91 percent reduction in discharges to nursing facilities.
Massive gaps leave practices more dependent on reimbursement from commercial payers and commercial contracts, raise the potential of shrinking number of Medicare patients accepted.
TPL reimbursements can recoup as much as 100 percent of charges levied, double commercial rates and more than triple governmental plan rates.
Two cases emerged from whistleblower claims about improper billing related to discounted drug prices and insulin pens.
Also, seven new insurers join America's Health Insurance Plans including Bright Health; CareFirst BlueCross BlueShield.
CMS' renewed interest in mandatory bundled payments includes the possibility of additional participation for oncology and other providers.
Arizona is the first state to exempt members of federally-recognized tribes.
Having a high deductible health plan without a health savings account was associated with greater hardship compared with low deductible insurance.
CMS also updates Medicare Advantage value-based insurance design, offering more benefits to attract beneficiaries and increase competition.