Mistaking Inaction for Action Hesitant leaders can easily raise the red flag at any one of the many unclear pathways to success, that Clinically Integrated Network (CIN) conversationalists claim when discussing the ability to cultivate true innovation capable of both…
In 2019 the Centers for Medicare and Medicaid (CMS) are making changes to the Quality Payment Program (QPP). Below are the most impactful changes we think you need to know about. For additional information, click one of the links at…
In recent years, the uneven playing field between the large carriers in Georgia and the rank and file physician practices across the state has become even more skewed toward these payers. More aggressive tactics have littered the physician landscape recently,…
CMS announced a major proposed adjustment to the vast majority of Accountable Care Organizations on Thursday, August 9 by re-branding the Medicare Shared Savings Program (MSSP) as the “Pathways to Success Initiative.” In essence, CMS Administrator Seema Verma intends to shorten…
Although Advanced Alternative Payment Models (APMs) haven’t spread like wildfire across the industry, the incentive to earn a 5% lump sum of yearly Medicare Part B payments and the ability to sidestep the MIPS program deserves attention. Although only ≈200,000…
Is accountable care more than just a buzzword? Even if it is, what can today’s healthcare provider even do about it? Although everyone from the private sector to CMS to the U.S. taxpayer agrees we are spending too much and…
As healthcare benefit costs continue to worry employers, health systems and employer groups are becoming more sophisticated in their approach to contracting directly. Direct-to-employer contracting deals from health systems allows both entities to both understand and gain more control…
When association health plans and short-term plans federal rules are fully phased in, about 4 million people will choose an association health plan and another 2 are predicted to be in a short-term plan of 12-months duration.
CMS announced that will be heightening audits to “confirm that Medicaid beneficiaries are correctly identified as expansion or pre-expansion enrollees”. States receive higher federal match rates of around 90% for expansion enrollees, while the match rate can be as low as 50% for pre-expansion enrollees.
According to Modern Healthcare, CMS wants to lunch “an experiment that allows doctors in Medicare Advantage plans to qualify as participating in an alternative payment model (APM).