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CMS Issues Final Rule for CY 2025 Medicare Advantage, Prescription Drug Plans
The Centers for Medicare & Medicaid Services (CMS) April 4 released its final Policy and Technical Changes to the Medicare Advantag
CMS Releases FY 2025 Long-term Care Hospital PPS Proposed Rule
The CMS on April 10 issued a proposed rule for the inpatient and long-term care hospital (LTCH) prospective payment systems (PPS) for fiscal year (FY) 2025.
CMS Releases Hospital Inpatient PPS Proposed Rule for Fiscal Year 2025
The CMS April 10 issued its hospital inpatient prospective payment system (PPS) and long-term care hospital (LTCH) PPS proposed rule for fiscal year (FY) 2025.
Inpatient Psychiatric Facility PPS: Proposed Rule for FY 2025
The CMS March 28 issued its fiscal year (FY) 2025 proposed rule for the inpatient psychiatric facility (IPF) prospective payment system.
Navigating Value-based Payment
In the 14 years since passage of the Affordable Care Act (ACA) and 9 years since the passage of the Medicare Access and CHIP Reauthorization Act (MACRA), there have been numerous programs developed by Medicare, states and commercial payers to support the movement to outcomes or value-based reimbursement.
Capitated and Global Budget Models
At the upstream end of the value-based payment spectrum, organizations can assume full risk for a population through capitated payments, global budgets, and provider led insurance plans.
Current and Emerging Payment Models
Health care is currently in the middle of a transition from a system of payment based on the volume of services provided (fee-for-service) to payment based on the value of those services (value-based care and alternative payment models).
Accountable Care Organizations
What are Accountable Care Organizations? What are ACOs? An ACO is a group of clinicians, hospitals and other health care providers who come together voluntarily to give coordinated high-quality care a designated group of patients.
CMS Releases FY 2025 Skilled Nursing Facility PPS Proposed Rule
CMS proposes a number of operational updates to the VBP program that would revise regulatory language to account for changes adopted for the program in previous rulemaking as well as general program policies.
CMS Releases FY 2025 Inpatient Rehabilitation Facility PPS Proposed Rule
The CMS March 27 issued its proposed rule for the inpatient rehabilitation facility prospective payment system for fiscal year (FY) 2025.