While numbers for MSSP participation starting this month are yet known, the figures will be an important measure of ACO willingness to take downside risk.
Category: Healthcare Finance News
Molina to acquire NextLevel Health Partners for $50 million, expanding footprint in Illinois
The deal will allow Molina to serve 50,000 new Medicaid and Managed Long-Term Services and Supports members in Cook County.
Significant underreporting in safety data found on Nursing Home Compare website
Just 57.5% of falls were accounted for in the Nursing Home Compare’s Minimum Data Set, which is self-reported by nursing homes.
Department of Justice claims Community Health Network fraudulently billed Medicare
CHN allegedly received referrals from physicians in violation of the Stark Law and submitted Medicare claims knowing they were ineligible.
Bright Health to expand Medicare Advantage market into California through purchase of Brand New Day
The expansion will bring the health plan’s national footprint to a total of 34 markets in 13 states.
Price transparency rule could lead to narrower networks, experts say
For capitalism to continue in healthcare, negotiations need to continue behind closed doors, one expert said.
Former Anthem executive Brad Smith named CMMI director
Smith co-founded Aspire Health, which Anthem acquired in 2018.
Healthcare paperwork cost U.S. $812 billion in 2017, 4 times more per capita than Canada
Doctors, hospitals, and other health providers in the U.S. spent far more on administration due to complexity.
CMS releases 2021 Medicare Advantage risk adjustment payment changes
Risk scores will be calculated using 75% encounter data, an increase of 25% over this year.
Owner of Los Angeles rehab center pleads guilty to $175 million healthcare fraud
The owner plead guilty to seven counts of grand theft, five counts of insurance fraud and one count each of identity theft and money laundering.
