Current & Emerging Payment Models
Some employers are moving away from offering traditional coverage with a provider network and instead are using reference-based pricing for some or all of services they cover. Under reference-based pricing, the employer (supported by a third party administrator [TPA] or other vendor) pays a set a…
Effective immediately, Medicare will pay $750 to administer monoclonal antibodies to COVID-19 patients in their residence or temporary lodging and increase payment to administer them in most other care settings to $450 from $310 to better align payment with provider costs, the Centers for Medicare…
The Centers for Medicare & Medicaid Services has selected 61 applicants for the Value in Opioid Use Disorder Treatment Demonstration, a four-year Medicare payment model beginning this month for selected health care providers who agree to participate.
Fifty-three organizations began participating April 1 in the first performance year of the Global and Professional Direct Contracting Model, the Center for Medicare and Medicaid Innovation announced.
The Centers for Medicare & Medicaid Services issued a proposed rule to update hospice payment rates for fiscal year 2022. CMS proposes a 2.3% ($530 million) net increase to payments, compared to FY 2021.
The Centers for Medicare & Medicaid Services issued a proposed rule to update skilled nursing facility payment rates for fiscal year 2022.
The Community Health Access and Rural Transformation Model will not seek applications from accountable care organizations until next spring, the Centers for Medicare & Medicaid Services announced.
Confidence in value-based arrangements has grown during the pandemic, notes William Shrank, M.D., chief medical officer at Humana.
For America’s hospitals, positive margins create the ability to invest in new facilities, treatments, and technologies to better care for patients, and to build reserves to be ready for a future made highly uncertain due to the effects of the COVID-19 pandemic.
The Centers for Medicare & Medicaid Services has selected 184 ambulance providers and suppliers in 36 states to participate in the Services Emergency Triage, Treat, and Transport (ET3) Model, which began Jan. 1.