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Assessing the Impact of COVID-19 on Rural Hospitals
The purpose of this research is to examine the impact of the COVID-19 pandemic on rural hospital financial performance.
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).
Bundled and Episode-Based Payment Models
Growing in popularity, bundled payment programs generally provide a single, comprehensive payment that covers all of the services involved in a patient's episode of care.
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.
The 340B Drug Pricing Program
For more than 30 years, the 340B Drug Pricing Program has provided financial help to hospitals serving vulnerable communities to manage rising prescription drug costs. Despite significant oversight from HRSA and the program’s proven record of decreasing government spending and expanding access to patient care, some want to scale it back or drastically reduce the benefits that eligible hospitals and their patients receive from the program.
CMS finalizes Medicare Advantage, Part D payment changes for CY 2025
The Centers for Medicare & Medicaid Services April 1 finalized proposed changes to Medicare Advantage plan capitation rates and Part C and Part D payment policies for calendar year 2025, which the agency estimates will increase MA plan revenues by an average 3.7% from 2024 to 2025.
AHA releases latest Health Care Plan Accountability Update
The AHA March 29 released its Health Care Plan Accountability Update, covering the latest developments in Medicare Advantage, legislation and regulation of private health insurers, as well as other resources from the last quarter.
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.