Bulletin Board
Bulletin Board
Alternative Payment Model Spending Grows
In 2016, 29 percent of all health care payments were made through alternative payment models, continuing the movement toward paying for value rather than for volume. That 29 percent in 2016 was up from 23 percent in 2015. APMs include shared savings and shared risk programs, bundled payments, and population-based payments. Fee-for-service and other “legacy” payments accounted for 43 percent of health care payments in 2016 and pay for performance or care coordination fees accounted for another 28 percent of payments. These numbers come from a report from the Health [...]
CMS Announces Drive to Reduce Paperwork
The Centers for Medicare & Medicaid Services is launching a new “Meaningful Measures” initiative that will seek to reduce the regulatory burden on health care providers. According to a CMS news release, Meaningful Measures …will involve only assessing those core issues that are most vital to providing high-quality care and improving patient outcomes. The agency aims to focus on outcome-based measures going forward, as opposed to trying to micromanage processes.. In a speech at the Health Care Payment Learning and Action Network, CMS administrator Seema Verma explained that this project [...]
CMS Nursing Home Program Cuts Hospital Admissions
An experimental Medicare program has helped nursing homes reduce the frequency with which their residents are admitted to hospitals. The Centers for Medicare & Medicaid Services’ Initiative to Reduce Avoidable Hospitalizations Among Nursing Facility Residents has reduced avoidable hospitalizations among nursing facility residents 17 percent in the program’s three years. 143 nursing homes in seven states participated in the program, which employed third-party vendors, known as enhanced care and coordination providers, to provide education to nursing facility staff. Hospitals, too, can benefit from the program because it may help reduce [...]
New Rules Facilitate Integration of Physical, Behavioral Care
New federal regulations are facilitating better integration of physical and behavioral health services for the Medicaid population. Two developments, in particular, are advancing this integration: the 2016 Medicare managed care rule and a 2016 rule implementing the Mental Health Parity and Addiction Equity Act of 2008. Together, these rules encourage providers to perform comprehensive assessments of their patients, increase flexibility for providers in how they use Medicaid payments, and pave the way for improvements in the use of information technology that foster better integration of physical and behavioral medical care. [...]
AMA: Health Insurance Concentration in Urban Areas Threatens Competition
Too much market share by insurers in urban areas can inhibit competition, and according to the American Medical Association, there is too little competition among insurers in too many urban markets today. According to a new AMA study, 69 percent of 389 metropolitan statistical area-level markets are “highly concentrated” in 89 percent of MSAs, at least one insurer issues at least 30 percent of commercial health insurance policies in 43 percent of urban MSAs, a single insurer owns at least 50 percent of the market In a statement accompanying release [...]