CMS Aims To Kickstart Rural ACOs With Medicare Payment Changes
The Centers for Medicare and Medicaid Services finalized updates Tuesday to the Medicare Shared Savings Program that include upfront payments to health providers in rural or underserved areas that join. Participation in the program has stalled since 2018.
Modern Healthcare:
CMS Updates Medicare Shared Savings Program To Encourage ACOs
The Centers for Medicare and Medicaid Services will invest in rural and underserved accountable care organizations and introduce more flexibility to the Medicare Shared Savings Program with the aim of kickstarting stalled enrollment and bridging health equity gaps. (Tepper, 11/1)
Axios:
An Overhaul For Medicare's Pay Transformation Program
The Biden administration is trying to jump start a Medicare program that pays health providers based on patient outcomes rather than by how many services they perform. The alternative payment effort was created through the Affordable Care Act, but participation has plateaued since 2018 amid waning interest from providers. The Biden administration finalized an overhaul of the initiative, known as the Medicare Shared Savings Program, on Tuesday. (Goldman, 11/2)
More on health care costs and insurance —
Axios:
Providers, Insurers And Employers Will All Face Health Care Inflation Costs
Employers, patients or taxpayers could be on the hook for hundreds of billions of dollars in additional health spending if providers and insurers successfully shift those inflation-driven costs, according to a recent McKinsey analysis. (Owens, 11/2)
Axios:
Congress May Face A Reckoning On Health Care Costs
All signs point to a crushing surge in health care costs for patients and employers next year — and that means health care industry groups are about to brawl over who pays the price. (Owens, 11/2)
Modern Healthcare:
Insurer Price Transparency Data Vex Developers
Alec Stein wanted to organize independent software developers to pour through health insurance data to determine what companies were paying to specific providers for particular services. Stein, a data bounty administrator at software company Dolthub, quickly ran into problems. (Tepper, 11/1)
AP:
EXPLAINER: How To Navigate Affordable Care Act Enrollment
The vast majority of Americans will find multiple options for health insurance coverage for 2023 on HealthCare.gov after open enrollment began Tuesday under the Affordable Care Act. People searching for plans on the government marketplace should consider their budget, health, doctors and a variety of other factors before picking a plan. (Lewis and Seitz, 11/1)
Modern Healthcare:
Health Insurance Markets Lack Competition, AMA Reports
Large health insurance companies dominated the commercial and Medicare Advantage markets in 2021, with consolidation shrinking competition and inflating premiums, the American Medical Association reports in a study published Tuesday. (Tepper, 11/1)
