News Clips
Fierce Healthcare: (11/23)– The Institute for Medicaid Innovation released a survey of Medicaid Managed Care Organizations that showed that fewer plans took advantage of value-based purchasing or alternative payment models. In 2020, 75 percent of Medicaid health plans were involved in such a structure, down by nearly 20 percentage points from the 93 percent in 2019. The survey also found 15 percent of respondents said that while they are not in such a structure, they plan to be with the next contract renewal.
Kaiser Health News (KHN): (11/22) – Overpriced doctors and other medical providers who can’t charge a reasonable rate for their services could be put out of business when new rules against surprise medical bills take effect in January, and that’s a good thing, Health and Human Services Secretary Xavier Becerra told KHN. Becerra said he did not foresee a wave of closures, or diminished access for consumers. Instead, he suggested that a competitive, market-driven process will find a balance, especially when consumers know better what they are paying for.
Modern Healthcare: (11/18) – During fiscal 2021, the Medicare fee-for-service program issued $25 billion in improper payments, or 6.2 percent of all reimbursements, a decrease from $20.72 billion over the past seven years and a historic low. The article authors cite provider consolidation as a factor for lowering improper Medicare payments. Aligning independent physicians to larger health systems offers them access to software for documenting patient conditions and codes.
Fierce Healthcare: (11/17) – Fewer providers in rural and underserved areas participated in advanced alternative payment models (APMs) compared to other providers over a two-year period, with the high cost a major barrier. The Government Accountability Office (GAO) released a report Wednesday covering the percentage of rural areas and places that have a small number of practitioners from 2017 to 2019. The report found 11.9 percent of providers in rural and underserved areas took part in advanced APMs in 2019, compared with 14.8 percent of providers not in such areas.
Modern Healthcare: (11/17) – The detente that allowed Congress to pass a law curbing surprise medical bills has disintegrated, with a bipartisan group of 152 lawmakers assailing the administration’s plan to regulate the law and medical providers warning of grim consequences for underserved patients. Many doctors, their medical associations and members of Congress are crying foul, arguing the rule released by the Biden administration in September for implementing the law favors insurers and doesn’t follow the spirit of the legislation.
Wall Street Journal: (11/16) – The Senate confirmed Jonathan Kanter on Tuesday as the Justice Department’s top antitrust official, adding a pro-enforcement lawyer to a Biden-administration team that has already been aggressive in addressing what it sees as threats to competition. Mr. Kanter, 48, was confirmed on a bipartisan 68-29 vote, as Democrats and some Republicans believe antitrust enforcers should be doing more to protect competition in the marketplace, including in the technology sector, agriculture and healthcare.
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