Health Care Policy
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CMS Proposes Hip/Knee Bundle Extension; Adds Outpatient Procedures
Bundled payment models have been used in health care for years. Medicare is proposing changes to its current, mandatory hip/knee replacement model. Here’s what you need to know.
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President’s Health Care Budget Continues Several Themes: Site Neutral, Value, Tech (and Cuts)
The President’s 2021 federal budget was released on February 10. While the document has no force of law, we take a look at a few ongoing themes.
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Ground-Breaking Fee Schedule for Social Determinants of Health
North Carolina is aggressively working to transform its Medicaid program, including a first-of-its-kind fee schedule for social determinants of health. Could their effort be a harbinger of future coverage and payment for SDoH?
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Final 2020 OPPS/ASC Rule Summary
CMS continues to embrace policies that further advance site neutrality and cost efficiency in its final 2020 OPPS rule. Review key OPPS policies and ASC policies in our summary.
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CMS Improves Care Management Reimbursement
CMS continues to believe in the importance of care management and provides a suite of positive improvements in the release of the 2020 final Physician Fee Schedule. Transitional and chronic care management codes are improved while principal care management codes are created.
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CMS Advances New Virtual, Telehealth Reimbursements
With the release of the final 2020 Physician Fee Schedule rule, the Centers for Medicare and Medicare continues to advance opportunities to provide telehealth and virtual health.
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Medicare Telehealth, Virtual Health Reimbursements Advance
Telehealth and virtual health reimbursements continue to improve. See the latest policies proposed by CMS in the 2020 Physician Fee Schedule rule.
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New Radiation Oncology Bundle Coming: What You Need to Know
If CMS has its way, a new mandatory model will roll out in 2020 to test site neutral payments in radiation oncology. Forty percent of the nation’s eligible radiation therapy episodes would be affected. Here’s what you need to know.
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Aging in Place and Reducing Health Care Spending? It’s Possible Under CAPABLE
We know seniors desire to remain at home for as long as possible. And, we know that Medicare and Medicaid desire to better manage health care spending. There is an innovative model already in use that is proving successful at meeting both goals. It’s called CAPABLE.
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The Rise of the Lawsuit: ACA, 340B, Drugs and Beyond
In a country with varied opinions on health care, expect to see the rise of the lawsuit to settle differences. Read about what is happening in key cases, like the ACA, and what those decisions will mean for the future.