- Center on Health Equity and Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
Medicare Payment Bump Proposed for Federally Qualified Centers
Federally qualified health centers would receive higher Medicare reimbursements starting next year, under a proposed rule issued by the CMS.
Federally qualified health centers would receive higher Medicare reimbursements starting next year, under a proposed rule issued by the CMS.
CMS will pay 30% higher rates to federally qualified centers under the proposal. The new prospective payment system will pay centers a single, bundled rate for each encounter that will cover all services. But the CMS will adjust payments to reflect the higher costs of some areas and provide an extra payment for an initial exam.
“The new payment system will help even more patients get care in federally supported health centers,” CMS Administrator Marilyn Tavenner said in a news release. “The services provided by these centers help ensure patients get important primary and preventive care that lowers costs and improves health outcomes.”
Right now, Medicare's payments to federally qualified health centers are based on reasonable costs, but are subject to established payment limits. However, under rules set out by the Patient Protection and Affordable Care Act, the new Medicare prospective payment system for the centers will use type, intensity and duration of services to help determine reimbursements, without regard to payment limits.
Read the full story here: http://bit.ly/18HCZlW
Source: Modern Healthcare
Prices for care at hospital trauma centers vary across hospitals; drug shortages reached a record high during the first quarter of 2024; although 3 of the biggest makers of asthma inhalers pledged to cap out-of-pocket costs for some US patients at $35, these do not apply to daily inhalers used by the youngest kids with asthma.
Read More
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.
Listen
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.
Read More
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.
Listen
