Reimbursement
Outcomes-based pricing models are bringing transparency to the often-murky orphan drug market.
Decreased labor expenses also contributed to the strong financial performance for the month, though non-labor expenses increased.
A decrease in private payer rates without an increase in government payment would threaten the air ambulance industry, Moody's says.
Legislative proposals could reduce bad debt, but would likely introduce additional complexity to billing processes.
A proposed rule seeks to stop the numerous schemes known to CMS that states have used to circumvent federal statute.
Using the power of data to tweak processes and squeeze the maximum amount of reimbursement possible is a must in today's environment.
A rule on hospital prices will be coming out alongside a proposal for health plan transparency, CMS Administrator Seema Verma says.
What looked like achievements of the program may have been a byproduct of factors driving a broader decrease in hospitalizations.
While the site neutral rule goes against court order, as does one on cuts for 340B payments, CMS said it is evaluating an option to appeal.
The rule also promotes competition and innovation in durable medical equipment by setting Medicare payment for new items based on commercial pricing data.