Medicare & Medicaid

Raising prices has been a common strategy after a private equity acquisition, and patient outcomes have suffered as well, group says.

CMS is expected to release the final inpatient payment rule later this spring.

When averaged out, the figure comes to 224% above Medicare rates for all employers and private insurers, down from 2018.

After the waiver, the share of patients with at least one outpatient telehealth visit climbed to about 10%.

Hospitals could face a greater number of uninsured patients as facilities remain financially strained by the COVID-19 pandemic.

Twenty-five percent of primary care physicians provided 86% of the care, and 25% of specialists, on average, provided 75% of the care.

Insurers are now required to pass along price concessions received from pharmacies at the point of sale.

A central concern about capitated payments is the potential to deny both access and payments in an attempt to increase profits, OIG says.

Standardized plan options will be required at every network type and at every metal level starting in 2023. 

<p class="MsoNoSpacing"><span style="font-size:11pt"><span style="font-family:"Calibri",sans-serif">This week's top stories include Physician Partners of America agreeing to pay $24.5M to settle a number of alleged violations, including unnecessary testing, and CMS estimates that payments to acute care hospitals will increase in 2023 by $1.6B. </span></span></p>