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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
What's at Stake as Oral Arguments Are Presented in the Braidwood Case? Q&A With Richard Hughes IV
April 21st 2025Richard Hughes IV, JD, MPH, spoke about the upcoming oral arguments to be presented to the Supreme Court regarding the Braidwood case, which would determine how preventive services are guaranteed insurance coverage.
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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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Comparing Breast Cancer Treatment Outcomes Between Fee-for-Service and Medicare Advantage
April 4th 2025This study examined postdiagnosis breast cancer treatment outcomes for Medicare Advantage vs fee-for-service (FFS) Medicare in Ohio and found no significant differences overall but disparities for Black patients with FFS Medicare.
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