Reimbursement
Advanced payment models should qualify as downside risk for advanced APMs under MACRA, AHA says.
Massachusetts wants the power to negotiate discounts for the drugs it purchases and to exclude drugs with limited treatment value.
Anthem Blue Cross and Blue Shield and Hartford Healthcare enter new three-year agreement retroactive to October 1.
Denver-area hospitals alone brought in a net income in 2016 of $1.3 billion, ACA helped boost payer performance, report said.
Hospitals challenged CMS after the agency gave a 0.2 percent downward adjustment to inpatient payment under the two-midnight rule.
Bill would negate a Centers for Medicare and Medicaid Services rule cutting $1.6 billion for drugs purchased by certain hospitals covered under the 340B program.
Suggestions include allowing enrollees to buy drugs at the pharmacy they prefer.
Improper payments decreased $5 billion from a total $36.2 billion due mostly to documentation errors.
The value-based models resulted in 6 percent fewer hospital inpatient admissions and 7 percent fewer emergency department visits.
The government said it intends to collect from insurers the full 2016 risk corridors payments this month.