Medicare & Medicaid
Due in large part to an aging baby boomer population, Medicare and Medicaid account for nearly 60 percent of top insurer revenues and 20 percent of their plan membership.
DOJ spokesperson said penalty could have been much higher if hospital had not fully cooperated with their year-plus investigation.
In the end, the program has shifted money away from physicians who treated sicker, poorer patients to pay for bonuses that rewarded practices treating richer, healthier populations.
Transportation to doctor's appointments and the pharmacy focuses on making sure MA members get needed care, medication for chronic conditions.
CMS Administrator Seema Verma said the agency will announce new voluntary payment bundles soon.
Layoffs for workers in Delaware follow hundreds in Phoenix earlier this month after loss of TriCare contract.
Integration with providers, narrow network ACO models, speaking members' languages and improving patient experience all key to earning, and keeping, an overall 5-star rating.
Hospitals and other providers spend nearly $39 billion a year solely on the administrative activities associated with regulatory compliance, AHA says.
In 25 states starting in 2019, plans will be able to provide Medicare beneficiaries with more choices and lower cost, CMS says.
Since Nov. 1, 2.27 million consumers have enrolled, outpacing the 2.13 million who signed up by Nov. 26, 2016.