Medicare & Medicaid
The timing of this switching has implications for how to measure growth in risk scores for new MA beneficiaries.
The total costs of additional staffing to meet a minimum staffing requirement would range from $1.5 to $6.8 billion, says CMS study.
AHEAD model includes financial incentives for hospitals and primary care practices.
Plaintiffs alleged that LVMC claimed and received payments that were not for "allowed medical expenses" permissible under state contracts.
CMS believes that eligibility systems in a number of states are programmed incorrectly, possibly leading to disenrollments.
Under the arrangement, members will be able to access Interwell's care and specialized resources.
Negotiations with participating drug companies will occur in 2023 and 2024, and prices will become effective beginning in 2026.
ACOs that earned shared savings tended to be low revenue small and rural hospitals or organizations made up of physicians.
Authors say MA growth means insurers are increasingly attempting to curtail inefficient use of post-acute care services.
The lawsuit alleges that the Medicaid redeterminations began a month before they were allowed under federal legislation.