While not as controversial as a prior proposal, Michigan’s work requirement waiver is still eliciting controversy—and its fate remains to be seen.
Category: FierceMarkets
Omada Health made its name with its technology. Now it’s luring insurers with operational innovation
Even Omada Health’s CEO Sean Duffy half-jokingly refers to the company as a provendor—a reference to the digital health company’s high tech roots melded with the billing approach of a provider (complete with an NPI). The identity has caused headaches f…
Payer Roundup—Payers not leaving ACA market in 2019; Medicaid coverage insufficient for foster children
A survey from eHealth says more than half of private payers will expand their individual market offerings in 2019, and only 7% will reduce them. Plus, Medicaid isn’t meeting foster children’s complex needs. Can managed care plans help?
NAACOs says ACOs saved Medicare nearly twice as much CMS’ estimates
NAACOs found a huge difference in how much ACOs save the Medicare program—a difference that has profound policy implications, it says.
With $200M investment, cancer practices launch startup OneOncology to help doctors keep independence
With a dedicated EHR platform through Flatiron Health, three large cancer practices are partnering to create economies of scale and push back against consolidation by pulling together more than 200 oncology providers at more than 100 care locations.
Social media dos and don’ts for doctors
Despite all of the benefits and pitfalls surrounding the use of social media by physicians, formal rules for medical professionals to follow online are still […]
Federal court nixes CMS overpayment rule, handing a big win to Medicare Advantage insurers
On Friday, a D.C. judge invalidated a 2014 rule that required Medicare Advantage insurers to report and return overpayments associated with incorrect diagnosis codes. The ruling could have a huge impact on an ongoing case against UnitedHealth and a fed…
MedPAC sings ‘chorus of compliments’ for revamped hospital quality measures
The commissioners debated its details, but overall, they were enthusiastic about a proposal to redesign Medicare’s hospital quality reporting system.
MedPAC searches for ways to reach Medicare-eligible individuals who still aren’t enrolled
Poor communication combined with a change in Social Security policy is keeping some people who are eligible for Medicare out of the program.
MedPAC considers ‘4-in-1’ post-acute care payment system
The commission could soon recommend a simplified, site-neutral system that would make costs more predictable and potentially pull SNFs, rehab facilities, long-term care hospitals and home health into one tiered system.
