Medicare & Medicaid
Valuable reforms designed to improve healthcare and lower cost hang in limbo, AHA says.
In all, 19 of 22 models predicted net savings in the first year after implementation, averaging 3.5% of total healthcare spending.
Every year, an estimated 1.3 million U.S. adults with heart disease may qualify for cardiac rehabilitation.
Over $2.1 billion arose from lawsuits filed by whistleblowers under the qui tam provisions of the False Claims Act.
The numbers for MSSP participation starting this month are an important measure of ACO willingness to take downside risk.
The deal will allow Molina to serve 50,000 new Medicaid and Managed Long-Term Services and Supports members in Cook County.
Just 57.5% of falls were accounted for in the Nursing Home Compare's Minimum Data Set, which is self-reported by nursing homes.
CHN allegedly received referrals from physicians in violation of the Stark Law and submitted Medicare claims knowing they were ineligible.
Smith co-founded Aspire Health, which Anthem acquired in 2018.
Risk scores will be calculated using 75% encounter data, an increase of 25% over this year.