- Center on Health Equity & Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
Medicare Payment Bump Proposed for Federally Qualified Centers
Federally qualified health centers would receive higher Medicare reimbursements starting next year, under a proposed rule issued by the CMS.
Federally qualified health centers would receive higher Medicare reimbursements starting next year, under a proposed rule issued by the CMS.
CMS will pay 30% higher rates to federally qualified centers under the proposal. The new prospective payment system will pay centers a single, bundled rate for each encounter that will cover all services. But the CMS will adjust payments to reflect the higher costs of some areas and provide an extra payment for an initial exam.
“The new payment system will help even more patients get care in federally supported health centers,” CMS Administrator Marilyn Tavenner said in a news release. “The services provided by these centers help ensure patients get important primary and preventive care that lowers costs and improves health outcomes.”
Right now, Medicare's payments to federally qualified health centers are based on reasonable costs, but are subject to established payment limits. However, under rules set out by the Patient Protection and Affordable Care Act, the new Medicare prospective payment system for the centers will use type, intensity and duration of services to help determine reimbursements, without regard to payment limits.
Read the full story here: http://bit.ly/18HCZlW
Source: Modern Healthcare
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.
Read More
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.
Listen
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.
Read More
