Medicare & Medicaid
Adults are four times as likely, and children at least two-times more likely, to receive certain preventative care services than uninsured, according to a report by America's Health Insurance Plans.
MA star ratings improvements can help plans expand their share of an increasingly saturated market.
Paying hospitals a fixed global budget reduced their prices but individual physicians continued to be paid on a fee-for-service basis.
"The survey strongly suggests that the majority of physicians would like to move away from the Medicaid status quo," Merritt Hawkins EVP says.
While conventional wisdom holds that it should be more challenging for doctors to bill private insurers, the results show that billing Medicaid is a bigger challenge.
The integrated provider-payer network is expected to grow as Lumeris builds a network of physicians and hospitals outside of the BayCare system.
While the MSSP overall was a net cost to CMS in 2016, there is evidence that individual ACO performance may improve with experience.
CMS is also increasing the percent of encounter data in risk scores, a move opposed by stakeholders.
The alliance is one of the first, if not the first, national blockchain alliances for healthcare, says Optum engineer.
AHA and three of its member hospitals had sued HHS due to the long delay in processing claims appeals.