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If the 5 percent bonus payment in the Advanced Alternative Payment Model (APMs) track was available in 2015, accountable care organizations (ACOs) would’ve earned additional net payments of $886 million if they had assumed downside risk under the Medicare Shared Savings Program (MSSP).

Most doctors saw a similar increase in compensation last year as they had in 2015, with an average raise of 2.9 percent across all specialties reported in the American Medical Group Association’s (AMGA) annual medical group compensation and productivity survey. Productivity, however, remained flat, and the move to value-based incentives in compensation continues to be slower than anticipated.

CMS has released its proposed rules for the 2018 Physician Fee Schedule (PFS), Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System, with the biggest change being halving the Medicare reimbursement for off-campus services.

President Donald Trump had proposed a 16 percent cut across HHS in his budget blueprint for fiscal year 2018, but the Republican majority on the House Appropriations Committee added $14.5 billion over his request in its own budget proposal released on July 12.

Jason Considine, senior vice president of patient collections and engagement at Experian Health, argued at the Healthcare Financial Management Association (HFMA) conference in Orlando that providers should first rely on leveraging data and crafting flexible payment options before paying any contingency fees to collectors. He spoke with HealthExec about mistakes providers are making with their collection practices and what data they need to improve the process.

 

Recent Headlines

ACA hits nation’s largest insurer’s bottom line

First quarter earnings for UnitedHealth Group Inc. show a 7.8 percent drop, reflecting in part the cuts to Medicare Advantage programs, new taxes and additional regulation created by the implementation of the Patient Protection and Affordable Care Act, the company said.

Physicians contributed $1.6 trillion to economy in 2012

A new report commissioned by the American Medical Association attempts to quantify the direct and indirect economic output of physicians in order to educate policy makers and the public.

Kansas cancer center settles with DOJ for $2.9 million

Hope Cancer Institute in Kansas City and its owner Raj Sadasivan, M.D., were accused of submitting Medicare claims for chemotherapy drugs that were never provided.

Lowell General Hospital and Tufts Medical Center form new health system

Boston’s prestigious Tufts Medical Center teaching hospital will partner with Lowell General Hospital, a community hospital with two campuses in Lowell, Mass., under a new parent company yet to be named.

ACA could raise your malpractice insurance rates

A key element of healthcare is leveraging technology and system efficiencies to allow individual providers to see more patients. But as the number of patients goes up, so does a provider’s malpractice risk according to a new study from the RAND Corporation.

Mergers and acquisitions continue at fast pace, especially for not-for-profits

A new report by independent consulting firm Kaufman Hall finds that U.S. hospital merger and acquisition activity increased 3 percent in 2013, with deals announced for 98 hospital and health system combinations.

Massachusetts state officials working to re-open bankrupt rural hospital

The abrupt closure of North Adams Regional Hospital in the rural community of North Adams, Mass., created a public outcry and has gotten legislators and policy makers involved in trying to broker a deal whereby another health system may be able to take over and re-open the facility.

ICD-10 delay positive for not-for-profit hospitals says finance firm

Credit ratings and research firm Fitch Ratings has analyzed the one-year delay on ICD-10 implementation and come to the conclusion that it will help more than hurt the finances of not-for-profit hospitals.

SC health system loses right to build new hospital to Tenet competitor

South Carolina’s fractured certificate of need (CON) process for new hospital construction has led to a protracted fight over who would be allowed to build a new hospital in Fort Mill, S.C. On Tuesday, a judge took the CON last awarded to Carolinas HealthCare System in 2011 and handed it to competitor Piedmont Medical Center, a hospital operated by a Tenet Healthcare subsidiary.

Montana’s largest healthcare provider adds medical center in Missoula

The Board of the non-profit community-owned Community Medical Center in Missoula, Mont., has approved a joint venture with the Billings Clinic and RegionalCare Hospital Partners that would, among other objectives, switch it to a for-profit entity.

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