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CMS to Private Insurers: Adopt Payment Reforms More Quickly
Leaders from the Centers for Medicare & Medicaid Services think private insurers have been too slow to adopt payment reforms, but they would be best served by adopting value-based payment systems in tandem with CMS today.
Leaders from the Centers for Medicare & Medicaid Services think private insurers have been too slow to adopt payment reforms, but they would be best served by adopting value-based payment systems in tandem with CMS today.
Alignment between public and private payers is key to making value-based models work, in order to “provide consistent incentives to clinicians and organizations,” wrote Rahul Rajkumar, MD, JD, a CMS senior advisor; Patrick Conway, MD, CMS’ deputy innovation and quality administrator; and Marilyn Tavenner, CMS administrator, in a viewpoint article published online this week by the Journal of the American Medical Association.
That doesn’t mean private payers need to adopt provider contracts identical to CMS’ or replicate their models.
Read the full story here: http://bit.ly/1jAmBtK
Source: Healthcare Payer News
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Navigating Health Policy in an Election Year: Insights From Dr Dennis Scanlon
April 2nd 2024On this episode of Managed Care Cast, we're talking with Dennis Scanlon, PhD, the editor in chief of The American Journal of Accountable Care®, about prior authorization, price transparency, the impact of health policy on the upcoming election, and more.
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The Biden administration recently launched the Global Health Security Strategy, a new effort to combat the spread of infectious diseases; lawmakers zeroed in on the risks of massive consolidation in health care during the first congressional hearing on the Change Healthcare hack; the FDA recently announced the recall of a pair of heart devices linked to numerous deaths and injuries.
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Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
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