Dr. Jacque Sokolov, MD, Chairman & CEO, SSB Solutions, Inc, says that value-based products and the revenue flow associated with them is evolving on the commercial side as well as the Medicare and Medicaid sides. The revenue sharing programs are contrasted with fee-for-service contracts. Dr. Sokolov also says that value-based reimbursement can have more than 5 revenue streams including quality metrics, shared savings, patient care management fees, and other areas where physicians and hospitals can recieve additional revenues for performance in value-based areas.
This video was taken on November 8 at the NAMCP Fall Forum in Las Vegas, NV.
At $531 billion, Medicaid is the second largest piece of healthcare spending and cannot be pushed off to be thought about another day, Cindy Mann, JD, CMS deputy administrator and director of the Center for Medicaid and CHIP Services, said at the America’s Health Insurance Plans’ National Conferences on Medicare and Medicaid and Dual Eligibles Summit.
No state-run exchange, no subsidy for health coverage. That’s what a federal judge in Oklahoma ruled yesterday, marking the second such ruling against a key component of the Affordable Care Act and setting up a potential return trip to the US Supreme Court to decide the fate of a key piece of the law.
The most recent Medicare Advantage and Part D program audits revealed that oversight of formulary administration is an area that health plans continue to struggle with, Sarah J. Lorance, vice president of Medicare Compliance at WellPoint, said at America’s Health Insurance Plans’ National Conference on Medicare and Medicaid and Dual Eligibles Summit in Washington, DC.
At the America’s Health Insurance Plans’ National Conference on Medicare and Medicaid and Dual Eligibles Summit in Washington, DC, Patrick Conway, deputy administrator for innovation and quality and chief medical officer for CMS, spoke on the future of delivery system reform.