The federal government’s funding of a value-based purchasing (VBP) demonstration project in the Medicare Advantage (MA) program did not improve quality of care, as measured by the plans’ five-star quality ratings. The findings from this demonstration … [Read more...] about Yet Again, Value-Based Purchasing Did Not Improve Quality
Medicare and Health Care Reform
Solution to Medicare Part B Cost Increases? Look at “Outpatient” Observation Status
If Congress and the Administration truly seek ways to limit Medicare premiums and deductibles, they ought to look at CMS's hospital Observation Status policy.A major cause of the Part B increase is likely the parallel increase in … [Read more...] about Solution to Medicare Part B Cost Increases? Look at “Outpatient” Observation Status
Center Submits Comments to CMS Proposal Concerning Medicare Advantage Value-Based Insurance Design Model
On September 1, 2015, the Centers for Medicare and Medicaid Services (CMS) issued an announcement concerning a demonstration called the Medicare Advantage (MA) Value-Based Insurance Design (VBID) model. (See: … [Read more...] about Center Submits Comments to CMS Proposal Concerning Medicare Advantage Value-Based Insurance Design Model
Reports of Import – Trustees and Kaiser Family Foundation
Medicare Trustees Report – Medicare Part A Solvency Remains StableOn July 22, 2015, the Medicare and Social Security Trustees issued the 2015 Annual Report of the Boards of Trustees of the Federal Hospital Insurance Trust Fund and the … [Read more...] about Reports of Import – Trustees and Kaiser Family Foundation
Supreme Court Victory for the Affordable Care Act and Access to Healthcare
June 25, 2015Today, the U.S. Supreme Court issued a decision in King v. Burwell (No. 14-114), a case challenging one of the central pillars of health insurance coverage offered through the Marketplaces, also known as Exchanges, created … [Read more...] about Supreme Court Victory for the Affordable Care Act and Access to Healthcare
Bundling Payments for Post-Acute Care
The traditional Medicare program pays individual health care providers for the specific services and care they provide to beneficiaries and guarantees that patients have “freedom of choice”[1] to select their Medicare providers. A … [Read more...] about Bundling Payments for Post-Acute Care
Center Attorneys Meet with Senate Finance Committee Staff Members About Changes to Medicare Appeals Process
The Medicare appeals system is not working. The success rate at the first two levels of appeal is staggeringly low for beneficiaries. It can take years to get an ALJ hearing decision – the third level of appeal, and the first real opportunity … [Read more...] about Center Attorneys Meet with Senate Finance Committee Staff Members About Changes to Medicare Appeals Process
Senate Finance Committee Holds Hearing on Medicare Appeals Backlog – Proposed Solutions Are of Great Concern
On April 28, 2015, the Senate Finance Committee held a hearing entitled “Creating a More Efficient and Level Playing Field: Audit and Appeals Issues in Medicare.”[1] As noted by Chairman Hatch in his opening statement, … [Read more...] about Senate Finance Committee Holds Hearing on Medicare Appeals Backlog – Proposed Solutions Are of Great Concern
Congress Passes “Doc Fix” – Senate Unable to Improve the Bill for Medicare Beneficiaries
On April 14, 2015, the Senate overwhelmingly (92 to 8) passed H.R. 2 – the Medicare and CHIP Reauthorization Act (MACRA) – which repeals and replaces the flawed Medicare physician reimbursement system known as the sustainable growth rate … [Read more...] about Congress Passes “Doc Fix” – Senate Unable to Improve the Bill for Medicare Beneficiaries
Medicare Myths vs. Facts – “Doc Fix” Edition
In the spirit of aiding the discussion concerning the budget and the SGR “Doc Fix,” we raise many of the myths surrounding Medicare and answer them with facts.Congress is working to repeal and replace the Sustainable Growth Rate … [Read more...] about Medicare Myths vs. Facts – “Doc Fix” Edition