Tag Archives: Medicare

How hospitals are prepping for Medicare’s mandatory bundled-pay test

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http://www.modernhealthcare.com/article/20151118/NEWS/151119898?utm_source=modernhealthcare&utm_medium=email&utm_content=externalURL&utm_campaign=mostreq

Competition Among Medicare’s Private Health Plans: Does It Really Exist?

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http://www.commonwealthfund.org/publications/issue-briefs/2015/aug/competition-medicare-private-plans-does-it-exist

Warner Chilcott to pay $125 million over kickback scheme, former drug company officials indicted

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http://www.healthcarefinancenews.com/news/warner-chilcott-pay-125-million-over-kickback-scheme-former-drug-company-officials-indicted?mkt_tok=3RkMMJWWfF9wsRovuKnPZKXonjHpfsX57u4rUa6zlMI%2F0ER3fOvrPUfGjI4ATMNkMa%2BTFAwTG5toziV8R7nHLs161sIQWRjg

Whistleblowers net $22.9 million for exposing drug company’s fraud.

Budget agreement would cut some hospital-based outpatient payments

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http://www.fiercehealthfinance.com/story/budget-agreement-would-cut-some-hospital-based-outpatient-payments/2015-10-28?utm_medium=nl&utm_source=internal

But most existing payments grandfathered in during negotiations

DOJ reaches $250M settlement with 457 hospitals to resolve Medicare billing dispute

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http://www.healthcaredive.com/news/doj-reaches-250m-settlement-with-457-hospitals-to-resolve-medicare-billing/408340/

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Is Observation Status Substituting For Hospital Readmission?

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http://healthaffairs.org/blog/2015/10/28/is-observation-status-substituting-for-hospital-readmission/

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Fed budget deal agreement looms large with major healthcare provisions

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http://www.healthcaredive.com/news/fed-budget-deal-agreement-looms-large-with-major-healthcare-provisions/408067/

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Are Medicare ACOs Working? Experts Disagree

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http://khn.org/news/are-medicare-acos-working-experts-disagree/

ACO

THIS MEDICARE ACO INITIATIVE HAS TWO PARTS:

  • The Medicare Shared Savings Program (MSSP), which is the largest group, comprises hospitals, doctors and other providers. It allows these organizations to opt against the risk of penalties for not meeting goals set by the program. But if they do that, they also are eligible for only lower shared savings.
  • The Pioneer Model comprises high-performing health systems. Groups in this program are eligible for higher levels of savings, but they must take on higher risks.

Difficile Est Primum Esse: How A Triple Whammy Undermined The Triple Aim

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http://healthaffairs.org/blog/2015/10/23/difficile-est-primum-esse-how-a-triple-whammy-undermined-the-triple-aim/

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