ACOs May Get Payment Boost In 2024 Under CMS Proposal
Though physicians are facing a pay cut under CMS' 2024 proposals, there is an upside in the plan for providers that participate in Medicare Shared Savings Program accountable care organizations: CMS wants to allow high-performing ACO providers to claim a share of the savings they generate early.
Modern Healthcare:
CMS ACO Proposals Give New Medicare Shared Savings Program Option
The Medicare pay cut looming for doctors next year comes with a sweetener for providers that participate in Medicare Shared Savings Program accountable care organizations. Although the Centers for Medicare and Medicaid Services proposed a 2.9% physician reimbursement reduction for 2025 on Wednesday — which would make five straight years of lower Medicare rates — the agency also wants to enable high-performing ACO providers to claim a share of the savings they generate early. (Early, 7/12)
Modern Healthcare:
Aetna Miscalculates No Surprises Act Reimbursement: CMS Audit
The Centers for Medicare and Medicaid services released its first No Surprises Act audit, listing a number of errors in how Aetna’s Texas division calculated reimbursement rates for air ambulance services. While the scope of the audit was very narrow, it shows how convoluted the reimbursement process is under the No Surprises Act, health policy experts said. (Kacik, 7/12)
Modern Healthcare:
Why GoodRx, Calibrate, Other Digital Health Founders Step Aside
Hard conversations are happening in the boardrooms of digital health companies, as directors assess whether the founding CEO with the great idea is the same person to lead the company's growth. The transitions are happening with increasing frequency as early-stage companies finding their footing and mature. In the last 18 months, the founders of Oscar Health, Calibrate, GoodRx, Tia, Particle Health, Eleanor Health and Clarify Health, among others, have stepped aside as CEO. (Perna, 7/12)
Axios:
Change Cyberhack Fallout Ripples To Consumers
The Change Healthcare cyberattack shook U.S. health care to its core for months and exposed major cyber vulnerabilities. But the likely ripple effects on individuals are only now becoming apparent. (Reed, 7/15)
CNBC:
Inside SimVET: A $43 Million Veterans Affairs Simulation Hospital
Inside a sprawling $43 million Veterans Affairs facility equipped with operating rooms, intensive care units and an outpatient clinic, there are no patients. At least not any real ones. (Capoot, 7/13)
