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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

Massachusetts hospital blamed for Medicare underpayments in other states

Miscalculations by Nantucket Cottage Hospital in Massachusetts in wages and costs in 2015 resulted in Medicare paying all hospitals in the state $133 million more than it should—creating a chain reaction that resulted in hospitals around the country being underpaid by CMS.

Pinnacle to affiliate with UPMC, buy 4 hospitals

Harrisburg, Pennsylvania-based Pinnacle Health announced it will more than double the number of hospitals within its system while also beginning an affiliation with the state’s largest health system, University of Pittsburgh Medical Center (UPMC). 

Fairview, HealthEast plan merger into 11-hospital system in Minnesota

Fairview Health Service and HealthEast Care System have announced their intention to merge, creating what is likely the largest health system in the Minneapolis-St. Paul area with a combined $5 billion in annual revenue.

Advocate, NorthShore scrap merger plans

A merger between two Illinois hospital systems, Advocate Health Care and NorthShore University Health Care, has been called off after a federal judge granted the Federal Trade Commission (FTC) a preliminary injunction against the deal.

McKesson, Change Healthcare finalize new IT company

The creation of a new data and analytics company, combining McKesson’s technology solutions unit with Nashville, Tenn.-based Change Healthcare, has been completed. The merger unites “the majority” of McKesson Technology Solutions with substantially all of Change, with the new company retaining the Change Healthcare name and Neil de Crescenzo as CEO.

Healthcare spending projected to make up almost 20% of U.S. economy by 2026

Health expenditures in the U.S. are expected to grow by an average of 5.6 percent annually through 2025, driven by rising medical prices that won’t be offset by slower growth in other areas.

Dueling lawsuits: Cigna wants $15 billion from Anthem; Anthem claims ‘sabotage’ of $54 billion merger

After their proposed merger was blocked by a federal judge, insurers Anthem and Cigna now have new opponents in court: each other.

Humana exiting ACA exchanges, individual market in 2018

Humana will be leaving all Affordable Care Act (ACA) exchanges and withdraw all its business from the individual insurance market in 2018, becoming the first major insurer to make a full exit amid uncertainty about the law’s future. 

Anthem files for expedited appeal of decision blocking Cigna merger

Anthem is asking the D.C. Circuit Court of Appeals to rush the appeals process as it tries to reverse a lower court’s ruling blocking its $54 million of acquisition of Cigna.

Aetna, Humana officially kill merger

Health insurers Aetna and Humana have mutually ended their $37 billion merger agreement two weeks after a federal judge blocked the deal on antitrust grounds. 

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