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ACOs Generated $300M in Savings Over 3 Years Via Lightbeam Technology

Accountable care organizations (ACOs) using Lightbeam technology have generated over $300M in savings over the last three performance years, since the Centers for Medicare & Medicaid Services (CMS) Medicare Shared Savings Program (MSSP) began. Show More Summary

Health Care Costs May Not Rise As Much as Projected

The Washington Post reported on new health care spending projections from the Centers for Medicare and Medicaid Services (CMS) which show spending rising to almost 20 percent of GDP by 2026 compared to 17.9 percent in 2016. It is worth noting that these projections have consistently overstated cost growth. Show More Summary

UC San Diego Health Selected as Accountable Care Organization

UC San Diego Health has been selected by Centers for Medicare & Medicaid Services (CMS) as one of 561 Accountable Care Organizations (ACOs), ensuring as many as 10.5 million Medicare beneficiaries across the United States have access to high-quality, coordinated care.

Free Press? Don't Need No Stinkin' Free Press - Center for Medicare and Medicaid Services (CMS) Tries to Intimidate Modern Healthcare Journalist

Remember the good ol' days, when most US challenges to free speech or the free press in health care came from aggrieved corporate or academic managers? Now government health agencies have gotten into the act, never mind First Amendment...Show More Summary

Medicaid Will Always Trample Someone's Values

Last week, the federal Centers for Medicare & Medicaid Services (CMS) issued a “guidance letter” that makes it easier for states to exclude abortion providers (chiefly Planned Parenthood) from Medicaid. According to the National Right...Show More Summary

New Part D Data: CVS Wins Big in 2018's Preferred Pharmacy Networks

Just-released data from the Centers for Medicare & Medicaid Services (CMS) confirms that preferred cost sharing networks will continue to dominate Medicare Part D. Our exclusive analysis finds that for 2018, 99.9% of seniors are enrolled...Show More Summary

109 Healthcare Groups Urge Congress to Immediately Reverse CMS Policy Linking Physician Payment Adjustments to Part B Drug Costs

More than 100 of the nation's leading patient and provider organizations - including the American College of Rheumatology - are urging Congressional leaders to immediately reverse a new Centers for Medicare & Medicaid Services (CMS) policy that will create enormous financial uncertainty for specialty providers and jeopardize patient access to vital Part B drug therapies.

Medicaid work requirements and the Kentucky 1115

Yesterday, the Center for Medicare and Medicaid Services (CMS) released a guidance letter to state Medicaid directors saying that CMS would welcome Section 1115 Waiver applications that contained work requirements.  The guidance would not provide any extra money for supportive employment or services and it’s logic chain of justifying employment as a condition of receiving […]

CMS to cover Abbott's glucose monitoring device

2 months agoHealth : Reuters: Health

(Reuters) - Abbott Laboratories said on Thursday its newly launched glucose monitoring device would be covered by the Centers for Medicare & Medicaid Services, expanding its usage to millions of diabetes patients in the United State...

Feel-Good Stories About Medicare CGM Coverage

Although those of us on Medicare are thankful that Centers for Medicare & Medicaid Services (CMS) now covers the Dexcom G5 continuous glucose monitor (CGM), many online discussions are angry and focused on the frustrating regulation that we are not allowed to use our smartphones, smart watches, and pumps as receivers. I wrote a blogpost about […]

Rush Hospitals Receive Five Stars for Quality of Care

Rush University Medical Center and Rush Copley Medical Center each have received five stars, the highest possible rating, for hospital quality from the federal Centers for Medicare and Medicaid Services. CMS, as the centers are known, published the latest overall ratings for hospitals nationwide on their Hospital Compare website today.

CMS Confirms It: Drug Spending Slows, Hospital and Physician Spending Grows

Last week, the econowonks at the Centers for Medicare & Medicaid Services (CMS) released the 2016 National Health Expenditure (NHE) data. Links below. It’s politically fashionable to blame healthcare spending growth on pharmaceuticals, but it’s also inaccurate. Show More Summary

New York’s BHP problem

Tim Jost at Health Affairs picks up on an important letter that the Center for Medicare and Medicaid Services (CMS) sent to New York. New York runs a Basic Health Plan. A BHP allows a state to take 95% of the funding for advanced premium tax credits (APTC) and cost sharing reduction (CSR) subsidies to […]

CMS Officially Cancels Mandatory Bundle Payment Models 

Today, the Centers for Medicare & Medicaid Services (CMS) has announced the cancellation of the mandatory hip fracture and cardiac bundled payment models that were to be operated by the CMS Innovation Center and implemented changes to the Comprehensive Care for Joint Replacement (CJR) Model. These changes will offer greater flexibility and choice for hospitals... Read More

VBID in Medicare Advantage

The Center for Medicare and Medicaid Services (CMS) announced late last week that they are expanding their Medicare Advantage Value Based Insurance Design (VBID) project (from Modern Healthcare) Insurers in 25 states will be able to apply for the Medicare Advantage Value-Based Insurance Design Model in 2019, the CMS announced Wednesday. The program is available […]

Southwestern Health Resources ACN Ranked No. 7 with Millions Saved, Quality Measures Above 95%

The Southwestern Health Resources Accountable Care Network (ACN) has saved the Centers for Medicare & Medicaid Services (CMS) more than $73 million over the past three years, including nearly $37.3 million in 2016, while maintaining a Quality Score over 95 percent, according to the latest figures. The savings rank the Southwestern Health Resources ACN No. 7 in the nation.

Will CMS Pop the Gross-to-Net Bubble in Medicare Part D With Point-of-Sale Rebates?

Last week, the Centers for Medicare & Medicaid Services (CMS) released its 713-page proposed policy changes and updates for the Medicare program. See the links below. Buried in this document is a radical concept: Part D plans would be required to recognize the value of manufacturer rebates and pharmacy payments in retail prescription prices. Show More Summary

American College of Rheumatology responds to CMS Innovation Center request for information

(American College of Rheumatology) The American College of Rheumatology (ACR) urged the Centers for Medicare and Medicaid Services (CMS) to remove barriers that make it difficult for subspecialists and providers in small practices to...Show More Summary

CMS Administrator Seema Verma To Outline Her Plan At 2017 Forbes Healthcare Summit

Seema Verma, the Administrator of the Centers for Medicare and Medicaid Services and a key figure in the future of the Affordable Care Act, will be interviewed live on-stage at the Forbes Healthcare Summit by Forbes Opinion Editor Avik Roy on November 30.

If Medicare wants value, it should cancel MACRA

From the CMS website, October 30, 2017, “Today, Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma discussed the agency’s efforts to streamline quality measures, reduce regulatory burden, and promote innovation … We need to move from fee-for-service to a system that pays for value and quality — but how we define value and […]

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