COA Asks CMS to Resolve Express Scripts’ “Underwater” Payments Following End of DIR Fees
February 27th 2024The Community Oncology Alliance (COA), which represents independent cancer care practices, has asked CMS to act following a dramatic drop in reimbursements from Express Scripts, Inc. effective January 1, 2024.
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Kathy Oubre on Strategies to Mitigate Challenges When Adopting New Payment Models
February 23rd 2024While adopting new payment models can come with challenges, there are strategies that can help oncology practices optimize their approaches, said Kathy Oubre, MS, CEO of Pontchartrain Cancer Center.
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Dr David Eagle: CMS Reimbursement Cuts Encourage Trend of Independent Physician Exodus
February 12th 2024Over the past 20 years, Medicare physician pay has plummeted by 26% when adjusted for inflation, while hospital reimbursement has surged by 70%, prompting over 100,000 doctors to abandon independent practice for hospital or corporate employment since 2019.
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Top 5 Most Popular Reimbursement Content of 2023
December 31st 2023The most popular reimbursement content of 2023 included coverage of the shift from the Oncology Care Model to the Enhancing Oncology Model, reactions to the 2024 Medicare Physician Fee Schedule, and concerns around denial of services in Medicare Advantage plans.
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Hospitals Report Declining Cash Reserves, Increasing Reimbursement Delays and Denials
December 1st 2023A new report highlighting the twin pressures hospitals have faced over the last 18 months shows that as reimbursement delays and denials increased and cash and investments decreased, operating expenses have risen sharply.
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AMA Continues Call for Medicare Payment System Fix During Interim Meeting
November 20th 2023The American Medical Association (AMA) is continuing to urge Congress to stop the impending 3.4% cut to physicians, and other organizations also weigh in on the pros and cons of the 2024 Medicare Physician Fee Schedule.
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What We’re Reading: UnitedHealth Lawsuit; Fentanyl Crackdown; Global Heat Deaths Increase
November 15th 2023A class action lawsuit was filed against UnitedHealth Group and a subsidiary for allegedly using an algorithm to deny rehabilitation coverage for seriously ill patients; US and China officials are finalizing an agreement to crack down on fentanyl; a study published Tuesday projected global heat deaths to increase by 370% if no action is taken against global warming.
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EOM Shows Awareness of Issues, but Provides No Resources, Says COA’s Nicolas Ferreyros
November 4th 2023The Enhancing Oncology Model is trying to address a number of the systemic challenges oncology faces without giving practices the tools and resources they need, said Nicolas Ferreyros, managing director of policy, advocacy, and communications, Community Oncology Alliance.
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Impact of Including Drug Spending in Oncology Alternative Payment Models
This study demonstrates a method for understanding the effects of drug spending in the design of alternative payment models.
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Confronting the Dynamics of Medicare Benefits When Those Eligible Are Still Working
October 24th 2023Community oncology practices are witnessing a new dynamic in which more Medicare-eligible patients are still covered by commercial insurance, according to speakers at the Community Oncology Alliance Payer Exchange Summit, held October 23-24, 2023.
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