Medicare & Medicaid
Part D drug spending projections are lower than last year because of slower price growth and a continuing trend of higher manufacturer rebates.
The Primary Care First payment model will provide payment to practices through a simplified total monthly payment to allow clinicians to focus on caring for patients rather than their revenue cycle, CMS says.
SNFs will be scored on a measure of potentially preventable hospital readmissions and on two new quality measures for interoperability.
Rule proposes no changes to practice of silver loading as insurers start to set rates for 2020.
Large hospitals and teaching hospitals are the most likely to see reduced penalties; those in states with high Medicaid enrollment will fare better.
Primary care represents an estimated 2.12 to 4.88 percent of total medical and prescription spending in Medicare Parts A, B and D.
This is less than half their 2016 average and below the 7.8 percent average of other U.S. hospitals, according to the annual study.
Mothers delivering via cesarean section covered by Medicaid had a 1.4 fold increase in infection compared to those covered by private insurance.
The scheme preyed upon hundreds of thousands of elderly and disabled patients, DOJ says.
Counties in states that expanded Medicaid had about four fewer deaths from heart disease per 100,000 residents compared to other states.