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Medicare & Medicaid

By Henry Powderly | 09:02 pm | August 25, 2015
While many accountable care organizations in Medicare's Shared Savings Program generated enough savings in 2014 to merit financial incentives, more than two-thirds fell below the payment threshold, the Centers for Medicare and Medicaid Services said on Tuesday.
By Henry Powderly | 11:13 am | August 25, 2015
Illinois-based RSA Medical provides analytics to health and life insurance companies that enables plans to identify medical conditions and other risk factors among enrollees and direct them to proper care.
By Henry Powderly | 03:13 pm | August 24, 2015
A new report published in the American Journal of Managed Care found that just over half of MSSP ACOs shared plans on how they'll allocate savings.
By Susan Morse | 10:52 am | August 14, 2015
State officials had requested hospitals receiving payments and health plans reimbursing hospital providers to certify none of the contractual arrangements are above 120 percent of the Medicaid fee schedule, the allowable limit.
By Henry Powderly | 08:30 am | August 14, 2015
CMS on Thursday said 360 organizations have directly entered into bundled payment agreements with the agency, and an additional 1,755 providers have partnered with those organizations as of July. But CMS acting administrator Andy Slavitt in June said there were more than 7,000 providers in the "at-risk" stage of the BPCI model.
By Susan Morse | 01:40 pm | August 12, 2015
CenseoHealth accused of targeting those MAO plan members who were likely to yield the most serious diagnoses, and more likely to generate higher capitation payments.
By Henry Powderly | 09:09 am | August 12, 2015
The Centers for Medicare and Medicaid Services said it will delay releasing data on its risk corridor ratios for insurers participating in health insurance exchanges after it found several discrepancies in the data.
By Healthcare Finance Staff | 07:47 am | August 12, 2015
The program saved $580 million in nine markets in the first round of bidding, which ended in 2013, and an additional $2 billion in the second round, which ended in July 2014.
By Susan Morse | 03:39 pm | August 11, 2015
These awards build on the $101 million awarded to 164 new health center sites in May 2015, bringing the total to 700 sites established with Affordable Care Act funding.
By Anthony Brino | 07:58 am | August 10, 2015
An estimated 45,000 American adults die each year because they have no health insurance, according a 2009 study in the American Journal of Public Health.