Tag Archives: payments

Verma defends cuts to navigators and halting risk adjustment payments

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Photo: Jeff Porter/AHCJSeema Verma, administrator for the Centers for Medicare and Medicaid Services, spoke at a briefing on public health emergencies at the CDC in December.

Seema Verma, administrator for the Centers for Medicare and Medicaid Services, was on defense on Thursday during a meeting with reporters who pushed her to explain a series of controversial decisions made by her agency in recent weeks.

The agency has faced accusations of sabotage by health advocates after the agency’s decisions to end risk payments to insurance companies offering plans on the individual market and to dramatically cut funding for navigators who help consumers sign up for coverage.  Continue reading →

Virgil Dickson reports for Modern Healthcare from Washington, D.C., on the federal regulatory agencies. Before joining Modern Healthcare in 2013, he was the Washington-based correspondent for PRWeek and an editor/reporter for FDA News.

#AHCJ17 panelists wrestle with the unintended consequences of complying with MACRA  

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Photo: Pia ChristensenRandi Terry (left), of Munson Healthcare in Traverse City, Mich., explains some of the difficulties of complying with MACRA and getting clarification from CMS on the rules.

Any legislation is bound to have unforeseen outcomes, and the Medicare Access and CHIP Reauthorization Act of 2015 is no exception, according to two members of a panel discussion on MACRA at Health Journalism 2017.

Anders Gilberg, senior vice president of government affairs for the Medical Group Management Association, and Randi Terry, director of information services for Munson Healthcare in Traverse City, Mich., described some of those unintended consequences. Continue reading →

Joseph Burns (@jburns18), an independent journalist who resides in Brewster, Massachusetts, is AHCJ’s topic leader on health reform. He welcomes questions and suggestions and tip sheets at joseph@healthjournalism.org.

Is value-based pricing doomed? #AHCJ17 session to address this question

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Paul Levy, former chief executive of Boston’s Beth Israel Deaconess Medical Center, recently made a compelling argument in a blog post about why value-based pricing for hospital services ultimately will fail.

In “The Game That Shows Why Value-Based Pricing Is Doomed” on AthenaInsight, Levy argues that the incentives in value-based pricing are all wrong. As a payment model, value-based pricing promotes selfishness but at the same time requires all parties to cooperate, he writes.

It’s not often that anyone criticizes value-based care, and why would they? That would be like opposing the use of grocery coupons. Continue reading →

Joseph Burns (@jburns18), an independent journalist who resides in Brewster, Massachusetts, is AHCJ’s topic leader on health reform. He welcomes questions and suggestions and tip sheets at joseph@healthjournalism.org.

Panel to examine MACRA, the physician payment overhaul law

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Given the ACA’s uncertain future, some experts have said that another law, MACRA, could lead the way on provider payment reform and accountable care innovations.

At the AHCJ’s Health Journalism 2017 conference in Orlando, a panel of providers will discuss their implementation of MACRA rules so far (reporting began on Jan. 1), and what the law means for their practices and their patients. A trade group representative from Washington, D.C., will give an overview of the law and where regulations stand in the Trump administration. Continue reading →

Rebecca Vesely is AHCJ's topic leader on health information technology and a freelance writer. She has written about health, science and medicine for AFP, the Bay Area News Group, Modern Healthcare, Wired, Scientific American online and many other news outlets.

Potential, implementation struggles of health IT highlighted at workshop

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Health information technology is fundamental to health care moving forward, said multiple speakers at the Journalism Workshop on Health Information Technology in San Francisco on Oct. 13 and 14.

“I view health IT as the circulatory system for health care,” said David Blumenthal, M.D., president of the Commonwealth Fund.

But Blumenthal and others said that now we are “struggling with the process” of realizing the full potential of health IT. Continue reading →

Rebecca Vesely is AHCJ's topic leader on health information technology and a freelance writer. She has written about health, science and medicine for AFP, the Bay Area News Group, Modern Healthcare, Wired, Scientific American online and many other news outlets.