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Prospective payment system

BPCI Model 3: Bonanza or boondoggle?

October 6, 2016  |  Kevin R. McMahon

There’s an argument to be made for being an early adopter with Bundled Payments for Care Improvement (BPCI) Model 3, but there are also questions about how much participants will ultimately save.

Medicare proposes changes to primary care payment

July 13, 2016  |  Nicole Stempak, Senior Editor

The Centers for Medicare and Medicaid Services has proposed changes to the Physician Fee Schedule to change how Medicare pays for primary care with an emphasis on care management and behavioral health.

MedPAC launches plan for new payment system

June 30, 2016  |  Robert Gatty

The Medicare Payment Advisory Commission (MedPAC) submits it recommendations to Congress for how to establish a unified, cross-setting post-acute care payment system. The plan would redistribute payments among types of stays, making profits more uniform and...

Unified PAC payment feasible, MedPAC says

June 25, 2016  |  Nicole Stempak, Senior Editor

The Medicare Payment Advisory Commission (MedPAC) has issued its annual report on refinements to Medicare payment systems and on issues affecting the medicare program

Innovation program to reduce nursing home hospitalizations

April 8, 2016  |  Nicole Stempak, Senior Editor

The Center for Innovation has invested more than $30 million for Indiana University’s project to reduce avoidable hospitalizations for nursing home residents by providing higher levels of care on site.

Proposed legislation aimed at comorbidity among Medicare beneficiaries

April 4, 2016  |  Robert Gatty

A U.S. Senate Working Group has outlined priorities for improving Medicare delivery to beneficiaries with multiple, complex chronic illnesses while reducing healthcare expenditures. 

New CMS initiative to improve care for nursing home residents

March 25, 2016  |  Nicole Stempak, Senior Editor

The Centers for Medicare & Medicaid Services (CMS) will test a new payment model for nursing facilities and practitioners to further reduce avoidable hospitalizations and lower Medicare and Medicaid spending while improving patient care.

CMS releases v1.13 of the RAI User's Manual

October 2, 2015  |  Lisa Hohlbein, RN, RAC-MT, CDP, CADDCT

The newly released RAI includes ICD-10 coding information and other clarifications.

CMS announces initiative to improve care in nursing homes

August 27, 2015  |  Megan Combs, Associate Editor

The new initiative provides funding to would allow nursing homes to test a new payment model.

CMS proposes physician reimbursement for end-of-life discussions

July 8, 2015  |  Pamela Tabar, Editor-in-Chief

In a milestone addition to its physician payment schedule, the Centers for Medicare & Medicaid Services proposes to add a new billing code to allow for the reimbursement of advanced care planning services.

CMS proposes SNF changes

April 20, 2015  |  Lois A. Bowers, Senior Editor

Payments to skilled nursing facilities, quality reporting, value-based purchasing and staffing data collection are addressed in a proposed rule published April 20 in the Federal Register.

SNFs, hospice and home health programs prominent in OIG work plan for 2015

November 25, 2014  |  Lois A. Bowers, Senior Editor

The billing, hiring, care-provision and deficiency-correction practices of nursing homes, hospices and home health programs are among the areas to be targeted by the U.S. Department of Health and Human Services Office of Inspector General in 2015.


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