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A bonus of up to 10 percent has been proposed for using an upgraded electronic health record (EHR) system for reporting in the Merit-based Incentive Payment System (MIPS) in 2018, but speakers at two recent industry conventions warned it’s likely not a worthwhile investment for providers.

When the previous administration at CMS finalized rules on mandatory bundled payment models for cardiac and orthopedic care late in 2016, 221 public comments were received. The cancellation of those same bundles, however, drew only 85 official comments as of Oct. 18.

Four accountable care organization (ACO) models generated more in gross savings in 2016, but unlike in previous years, CMS hasn’t publicly touted the results as it re-examines payment models created under the Centers for Medicare and Medicaid Innovation (CMMI).

The U.S. Department of Justice (DOJ) has abandoned a lawsuit against UnitedHealth over allegations the insurer submitted false claims in its Medicare Advantage plans, though a similar case remains active.

Private investors are becoming increasingly active in healthcare acquisitions, which may maximize the purchase price when practices decide to sell, but there are downsides to these transactions compared to be absorbed into a hospital or health system.

 

Recent Headlines

EDs may charge 12.6 times Medicare prices—with higher markups than other departments

Emergency department services like suturing a wound or interpreting a CT scan may result in patients being charged up to 12.6 times more than what Medicare would pay, with minorities and uninsured patients the most likely to be hit by the markups.

Aetna moving its HQ out of Connecticut, considering ‘several states’

Aetna confirmed it is in negotiations to move its corporate headquarters out of Hartford, Connecticut, which was been its home since it began as a fire insurance company in 1819.

CHS to sell 5 hospitals to Reading Health System

The selloff of Community Health System (CHS) hospitals is continuing, as the struggling hospital operator agreed to sell five Pennsylvania hospitals to the not-for-profit Reading Health System.

Steward would become largest for-profit hospital operator after IASIS merger

Boston-based Steward Health Care System would become the largest for-profit hospital operator in the U.S. if it wins regulatory approval for a $2 billion merger with Franklin, Tennessee-based IASIS Healthcare. 

HFMA ANI 2017 preview: ‘Healthcare finance has always been about change’

Policy uncertainty, changing reimbursement models and price transparency are just some of the topics expected to be discussed at the Healthcare Financial Management Association’s upcoming Annual National Institute, which runs from June 25 to 28 at the Orange County Convention Center in Orlando, Florida. 

UnitedHealth hit with another DOJ lawsuit over Medicare Advantage fraud

The U.S. Department of Justice (DOJ) is again involved in a lawsuit alleging UnitedHealth Group (UHG) received Medicare Advantage payments to which it wasn’t entitled.

HFMA announces 2017 revenue cycle awards

Seventeen healthcare organizations have been named winners of the 2017 MAP Award for High Performance in Revenue Cycle by the Healthcare Financial Management Association (HFMA).

Kaiser, Ascension see big gains in operating income

Financial reports for Kaiser Permanente and Ascension Health saw double-digit increases in operating income, with some of the gains credited to acquisitions both systems have made in the past year.

Anthem kills Cigna merger, promises to pursue damages

After losing in court for the third time over the $54 billion deal, Anthem has officially terminated its merger with Cigna, though the court battles involving the failed acquisition appear to be far from over.

Top 10 MACRA trends challenging providers

The need for new or upgraded software, provider consolidation and hiring consultants are some of top trends practices will need to contend with as they prepare for the new payment tracks in the Medicare Access and CHIP Reauthorization Act (MACRA).

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