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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.
The First 1,000 Days of Life: Creating Brighter Futures for New Moms and Babies
In this conversation, two experts from Intermountain Health discuss their "First 1,000 Days of Life" Initiative that provides wraparound services for at-risk new moms.
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.
Inpatient Prospective Payment System (IPPS)
Find out what Medicare's Inpatient Prospective Payment System IPPS in healthcare is. More than three-quarters of the nation's inpatient acute-care hospitals are paid under the inpatient prospective payment system, while nearly a quarter are paid based on costs and are called Critical Access Hospitals. The IPPS pays a flat rate based on the average charges across all hospitals for a specific diagnosis, regardless of whether that particular patient costs more or less. What is Inpatient PPS?
CMS proposes 4.1% payment update for SNFs and revise nursing home enforcement authority in FY 2025
The Centers for Medicare & Medicaid Services March 28 issued a proposed rule for fiscal year 2025 for the skilled nursing facility prospective payment system, which would increase aggregate Medicare spending by 4.1% or $1.3 billion compared with FY 2024.
Inpatient psychiatric facilities rule would increase payments 2.6%, clarify all-inclusive cost reporting
The Centers for Medicare & Medicaid Services today issued a proposed rule for the inpatient psychiatric facility prospective payment system for fiscal year 2025.