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Do mandatory bundled payments lower health spending? A new study suggests yes—but only slightly.

January 8, 2019

A new study suggests Medicare's Comprehensive Care for Joint Replacement program led to a modest reduction in spending on hip and knee replacement surgeries over a two-year period.

How CMS plans to change MA's risk adjustment model in 2020

January 3, 2019

CMS in an advance notice details how the agency in 2020 plans to change the way it calculates risk scores used to determine payments for Medicare Advantage plans.

CMS cracked down on hospital readmissions. But did that policy cause more harm than good?

January 3, 2019

While the reduction in Medicare readmissions under the Hospital Readmissions Reduction Program (HRRP) initially might have "seemed like the win-win that policymakers had" sought, "a deeper look at [HRRP] reveals a few troubling trends," a group of cardiologists and health policy researchers write in a New York Times opinion piece.

CMS finalizes rule to make ACOs take on more risk

January 2, 2019

CMS has finalized a rule to overhaul the Medicare Shared Savings Program and accelerate the pathway for accountable care organizations to transition to two-sided risk models.

A judge just ruled that 340B cuts are illegal (but the rule hasn't been vacated yet)

January 2, 2019

A federal district court judge last week ruled HHS unlawfully cut Medicare Part B reimbursements for drugs purchased via Medicare's 340B program, siding with the American Hospital Association and other hospital groups.

Clinical lab fees to rise for the first time in decades

January 2, 2019

CMS last week issued a notice that the agency is increasing the fees diagnostic laboratories pay to be regulated by 20%, marking the first increase in roughly 20 years.

Dozens of physicians failed to disclose industry ties. Should that be considered misconduct?

December 19, 2018

Dozens of physicians in the past few years have failed to disclose their financial ties to the health care industry when they have published research in medical journals, according to a New York Times and ProPublica analysis—and some experts say those lapses warrant misconduct charges.

In the states: 4,000 mental health providers strike in California, Maine ordered to expand Medicaid in 2019, and more

December 14, 2018

American Health Line rounds up the latest health care news in the states.

SCOTUS declines to hear case on whether patients can sue states over Medicaid funding

December 11, 2018

The Supreme Court denied requests from Kansas and Louisiana to hear cases regarding whether patients can challenge how states choose to allocate Medicaid funds—a decision that leaves in place lower court rulings barring the states from terminating Medicaid contracts with Planned Parenthood.

Meet John O'Brien, Azar's new senior adviser on drug pricing

December 10, 2018

John O'Brien, a former executive at CareFirst Blue Cross Blue Shield, will oversee the Trump administration's implementation of a proposed Medicare Part B drug pricing model intended to bring provider reimbursements in line with prices paid in other countries.

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