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CMS to Drop Price of Medicare Provider Data
The Centers for Medicare & Medicaid Services (CMS ) will lower the planned price of Medicare provider data under a final rule issued today, after the regional groups that wanted the data to create quality reports complained that previously proposed prices would keep them from participating.
The final rule implements a program—authorized by the Patient Protection and Affordable Care Act—that allows qualified organizations to access patient-protected Medicare data and produce public reports on physicians, hospitals and other healthcare providers.
Such reports, according to the agency, would combine Medicare claims data with private-sector claims data to identify the physicians and hospitals that provide the highest quality, most cost-effective care to patients.
The changes in the final rule from the original rule proposed in June included a requirement that the provider data cost less than originally proposed for qualified entities.
Under the earlier proposed version, data for 2.5 million beneficiaries would have cost $200,000. The final design would lower the costs for the same number of beneficiaries to $40,000 for the first year and $32,000 for each subsequent year.
Source: Modern Healthcare
Joanne Mizell: Lifestyle Modification Programs Take Holistic Aim at Metabolic Disease
May 1st 2024Joanne Mizell shares insurer strategies in addressing the escalating rates of metabolic diseases, highlighting the importance of holistic treatment methods like lifestyle modification programs, which integrate nutrition, physical activity, and community engagement.
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Tackling Health Inequality: The Power of Education and Experience
April 30th 2024To help celebrate and recognize National Minority Health Month, we are bringing you a special month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. Welcome to our final episode of this limited series and our conversation with Janine Jelks-Seale, MSPPM, director of health equity at UPMC Health Plan.
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Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
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The Federal Trade Commission (FTC) issued letters to 10 companies to warn them that certain drug patents were improperly listed; the US Department of Agriculture (USDA) will begin testing ground beef for bird flu particles; rural Americans are more likely to die early from 1 of the 5 leading causes of death than those who live in urban areas.
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