Reimbursement
The federal bundled payments effort may promise providers a share in savings when they improve quality and lower costs, but it will likely take the squeeze in fee-for-service Medicare payments to drive many providers to participate in the new delivery model. Private payers have a role in leading on this transformation.
Health Care Incentives Improvement Institute (HCI3) has released a new version of its episode of care analysis freeware aimed at helping providers wanting to take part in the Center for Medicare & Medicaid Innovation's (CMMI) Bundled Payments for Care Improvement initiative.
Small and resource-poor, the Western Washington Rural Health Care Collaborative (WWRHCC), has shown it is not afraid to tackle - and complete - big projects, such as building an HIE from scratch and developing a telepharmacy system.
A new high-deductible insurance plan from UPMC Health Plan will reward members who become more involved in their healthcare decisions and exhibit healthy behaviors via participation in more than 100 approved activities.
Few seniors are familiar with the Medicare Star Quality Ratings for Medicare plans from the Centers for Medicare & Medicaid Services and even those who do know about them rarely use the information to help select their Medicare plan.
HealthAmerica and Preferred Primary Care Physicians have launched a new pilot program aimed at providing more coordinated and patient-centered primary care and improved communications among patients, physicians and care teams.
Alternative benefit models rely on cost-sharing approaches for seniors, while some MedPAC members urged benefits that encourage changing unhealthy behaviors.
Aetna and CVS/pharmacy announced last week a co-branded Medicare prescription drug plan available in 43 states and Washington, DC, in a deal that will leverage the retail base of more than 7,200 CVS and Long Drug stores across the country.
Consumer organizations may find opportunities to partner with health plans in the coming years as more health reform changes take affect in the coming years.
The Office of the Inspector General has discovered that some nursing homes are charging Medicare more then they should for resource utilization groups, and they want to put a stop to it.