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CMS to Private Insurers: Adopt Payment Reforms More Quickly
Leaders from the Centers for Medicare & Medicaid Services think private insurers have been too slow to adopt payment reforms, but they would be best served by adopting value-based payment systems in tandem with CMS today.
Leaders from the Centers for Medicare & Medicaid Services think private insurers have been too slow to adopt payment reforms, but they would be best served by adopting value-based payment systems in tandem with CMS today.
Alignment between public and private payers is key to making value-based models work, in order to “provide consistent incentives to clinicians and organizations,” wrote Rahul Rajkumar, MD, JD, a CMS senior advisor; Patrick Conway, MD, CMS’ deputy innovation and quality administrator; and Marilyn Tavenner, CMS administrator, in a viewpoint article published online this week by the Journal of the American Medical Association.
That doesn’t mean private payers need to adopt provider contracts identical to CMS’ or replicate their models.
Read the full story here: http://bit.ly/1jAmBtK
Source: Healthcare Payer News
Trump Administration’s Message to Supreme Court Puts New Wrinkle in Braidwood Case
February 21st 2025The Trump administration argues that HHS Secretary Robert F. Kennedy Jr can overrule the US Preventive Services Task Force to determine the preventive services covered under the Affordable Care Act.
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Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
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5 Key Health Care Moments During President Trump's First Month Back in Office
February 21st 2025President Donald J. Trump pushed for significant health care changes during his first month back in office, through executive orders affecting managed care, drug pricing, and clinical trial diversity guidance.
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Same-Day Breast Imaging Gaps Reveal Health Care Disparities
February 18th 2025For this retrospective study, the authors examined data on more than 3 million screening mammographies for more than 1 million female patients; of the screenings, 23.6% had abnormal results and only 6.7% were recommended for biopsy.
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