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…
Providers are fiercely opposing changes in two CMS payment rules for 2021, decrying physician rate cuts amid the COVID-19 pandemic, pushing for more telehealth flexibility and urging a stop to a controversial plan to eliminate the list of procedures that can be done on an inpatient-only basis. CMS released its annual proposals for the Physician…
As if things weren’t dramatic enough already in U.S. healthcare, a “battle of the narratives” has developed between senior officials at the Centers for Medicare & Medicaid Services (CMS), especially CMS Administrator Seema Verma, and the leaders of NAACOS— the National Association of ACOs—which have been locked in an ongoing war of words with each…
CMS has issued a letter to Medicaid directors regarding how states can accelerate their Medicaid value-based care adoption, based largely on lessons learned in CMS efforts toward value-based care in Medicare. “The Trump Administration has long worked to accelerate the overdue move to value-based care, but for too long these efforts have been piecemeal,” said CMS Administrator…
Over the last three years, under the Trump Administration, the Centers for Medicare & Medicaid Services (CMS) has been advancing innovative payment and service delivery models to help move our health care system from one that pays for volume to one that rewards providers for keeping patients healthy, improving health outcomes and lowering costs. A…
The Centers for Medicare and Medicaid Innovation on Tuesday unveiled a new alternative payment model for rural providers. The Community Health Access and Rural Transformation—CHART—model will give rural communities money upfront to change how they pay for and deliver care to Medicare beneficiaries. It will also provide them with operational and regulatory relief, as well as technical…
During the Coronavirus pandemic, the Centers for Medicare and Medicaid Services (CMS) has taken unprecedented action to expand telehealth for Medicare beneficiaries. Since people were advised to stay at home to reduce risk of exposure of COVID-19, there was an urgency to increase access to telehealth services to help people who need routine care and…
CMS should keep the 2021 application cycle for the Medicare Shared Savings Program (MSSP) open and implement other changes to the program to protect providers from excessive costs incurred during the pandemic, the American Medical Group Association (AMGA) recently urged. “CMS has instituted a number of changes to support providers and their patients during the…
Among the industry experts who spoke with Healthcare Innovation in participating in the development of this year’s Ten Transformative Trends cover story package in the May/June issue of the publication was Christopher Kerns, vice president for executive insights for Advisory Board, a Washington, D.C.-based research division of the Minneapolis-based Optum. Editor-in-Chief Mark Hagland interviewed Kearns for the “ACOs…
As healthcare providers continue to respond to the COVID-19 crisis, CMS is granting key flexibilities to participants in alternative payment models (APMs) managed by the agency’s Innovation Center. CMS Administrator Seema Verma announced yesterday in a Health Affairs blog post that the agency is adjusting APM to address “the uniqueness of the situation.” Among the adjustments announced was…