Medicare & Medicaid
Enrollment in MA is projected to increase by 11.5 percent, and the number of plans to increase by 600 next year.
Payers are almost equally as likely to get decision support from websites than from consulting with colleagues.
One of the issues is that while costs are rising, consumers aren't prepared, as many are struggling with rising premiums and out-of-pocket expenses.
The International Pricing Index model would reset Medicare payments for physician-administered drugs.
Many physician practices lack the experience with data management and analysis needed to perform well in alternative payment methods, study says.
Some providers see nine percent of their claims denied, and with each costing as much as $118, better processes can help realize cost savings.
ACOs in upside-only models need more than two years and the shared savings rate put forward by The Centers for Medicare and Medicaid Services, lawmakers and stakeholders say.
In contrast, 41 percent of payments were based on volume rather than quality and efficiency, two hallmarks of value-based care.
States will have the ability to allow individuals to use ACA subsidies when buying short-term limited duration plans.
Open enrollment, which begins November 1, will not be negatively impacted, CMS says.