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Fewer ACOS joined MSSP in 2019—but more are taking on risk, data show

July 19, 2019


Fewer accountable care organizations (ACOs) joined the Medicare Shared Savings Program in 2019 than in 2018—but more ACOs are taking on financial risk than in previous years, CMS Administrator Seema Verma announced in a Health Affairs blog published Wednesday.

Senate's 'surprise billing' legislation would save $7.6B over 10 years, CBO predicts

July 18, 2019


The Senate Health, Education, Labor and Pensions Committee's legislative package to address out-of-network "surprise" medical bills would reduce average national provider payment rates by as much as 20%—with much of the effect due to a reduction in in-network payment rates, according to a Congressional Budget Office report released Tuesday.

MACRA's Advanced APM track attracted more clinicians in 2018, CMS says

July 17, 2019


The number of clinicians who participated in MACRA's Advanced Alternative Payment Model track increased from 2017 to 2018, while the number of clinicians who participated in MACRA's Merit-based Incentive Payment System decreased, according to preliminary data CMS released Thursday.

House panel advances bill to address 'surprise' medical bills—but will it go any further?

July 15, 2019


The House Energy and Commerce Health Subcommittee on Thursday advanced a bill to address so-called "surprise" medical bills by setting a benchmark payment rate for out-of-network services.

Inside the 346-page Home Health Prospective Payment System proposed rule

July 15, 2019


CMS on Thursday released a proposed rule to update certain Medicare payment regulations under the Home Health Prospective Payment System and increase payments for home health agencies by 1.3%.

CMS proposes mandatory bundled payment model for radiation oncology

July 12, 2019


CMS on Wednesday issued a proposed rule to implement a mandatory bundled payment model intended to replace Medicare's current fee-for-service payment model for radiation oncology in certain geographic regions.

Trump drops fight to add citizenship question to census survey

July 12, 2019


President Trump on Thursday announced that his administration will not add a controversial citizenship question to the 2020 U.S. Census, reversing an announcement he made last week and effectively ending a dispute over the question.

Trump just pulled his proposal to eliminate Rx drug rebates. Here's why.

July 11, 2019


The Trump administration has withdrawn its proposed rule to prohibit drugmakers from paying rebates to pharmacy benefit managers under federal health programs, a White House spokesperson confirmed Wednesday.

Inside Trump's plan to overhaul kidney care, donation process

July 11, 2019


President Trump on Wednesday issued an executive order that calls on HHS to overhaul the kidney care and donation allocation process, and HHS shortly after unveiled new payment models for Medicare providers who manage patients with kidney disease and end-stage renal disease.

How much do air ambulances charge private insurers? More than four times Medicare rates, study finds.

July 10, 2019


Charges for air ambulance services in 2016 were more than four times higher than the rate Medicare paid to transport patients via airplane or helicopter, according to a study recently published in Health Affairs.

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