The Trump administration on Thursday issued its final rule requiring nearly all health insurers and self-insured plans to disclose pricing and cost-sharing information. The Transparency in Coverage rule will force employer health plans and insurance companies to post in-network and out-of-network rates they negotiate with providers. It also requires insurers to develop online price transparency tools…
The federally appointed Physician-Focused Payment Model Technical Advisory Committee said Tuesday it has recommended HHS consider a payment model focused on asthma care. The payment model, if approved by HHS, would provide allergists, immunologists and pulmonologists a value-based payment option. A longstanding complaint of the movement to alternative payment models is it has excluded many specialists from…
HHS on Monday launched an ambitious, double-pronged strategy to shift primary care from fee-for-service payments to a global fee model where clinicians and hospitals could assume varying amounts of risk. HHS Secretary Alex Azar told a crowd of stakeholders at the American Medical Association in Washington that the CMS projects the new voluntary programs will…
What might be in the works over at the Centers for Medicare and Medicaid Innovation (CMMI)? Are there new pilot models actively in development that will be rolled out this year? Many industry stakeholders, including federal lawmakers, are eager to know what the relatively opaque agency has in store. Created under the Obama administration, CMMI…
Excerpt: “Social determinants of health is an abstract term, but for millions of Americans, it is a very tangible, frightening challenge: How can someone manage diabetes if they are constantly worrying about how they’re going to afford their meals each week? How can a mother with an asthmatic son really improve his health if it’s…
Secretary of Health and Human Services (HHS) Alex Azar said that moving to a value-based healthcare system is a top priority for the Trump administration, speaking Thursday at the Patient-Centered Primary Care Collaborative annual conference here. Azar also stressed that to achieve this transformation requires “real experimentation” using mandatory payment models. “I want you all…
Improving preventive care, increasing patient access to care, and addressing societal stigma will be the linchpins in addressing the opioid crisis that ravages the nation, according to a new report from the Surgeon General. The report, Spotlight on Opioids, looks at the national public health crisis that led to 115 opioid-related deaths on any given…
The Center for Medicare and Medicaid Innovation will soon launch “new, bold” models for value-based care — and they might be mandatory, according HHS Secretary Alex Azar’s remarks at a Sept. 6 meeting in Washington, D.C., for the Physician-Focused Payment Model Technical Advisory Committee. Despite the growth in coordinated care and value-based pay, alternative payment…
Earlier this week, CMS (the Centers for Medicare & Medicaid Services) Administrator Seema Verma remarked that “upside-only” ACOs (accountable care organizations) that do not take on downside risk have not generated enough results to date. Now, Healthcare Informatics has learned that a CMS rule is forthcoming that could shorten the duration ACOs can stay in…
ALEX AZAR LAYS OUT VALUE-BASED CARE AGENDA — The HHS secretary’s four stated priorities, presented at a Federation of American Hospitals conference, generally mirror what the Obama administration pushed in its final years in office, POLITICO’s David Pittman reports. The methods for achieving those goals, of course, will likely look different. — Azar priority #1: Allow…