Doctors Face Tough Choice With New Options For Reimbursement
The new doctor payment system established by the Medicare Access and CHIP Reauthorization Act will force providers to opt into one of two reimbursement models that have different risks. Also, Medicare's efforts to change how the system pays for a variety of different services is hitting opposition in the health care industry, and federal officials have announced changes for some Medicare Advantage plans.
Most Providers Will Opt To Avoid Too Much Risk Under Medicare's New MACRA Payment System
Hospital boardrooms are beginning to sound more like those on Wall Street, with talk of upside and downside risk, capitation and a hefty addition of new acronyms. Hospitals, health systems and physician groups are now in the process of deciding which of the two possible reimbursement paths they will take under the Medicare Access and CHIP Reauthorization Act, which replaced the rarely implemented sustainable growth-rate formula for determining physician pay. (Muchmore, 8/13)
Medicare Changes Fiercely Resisted
The Obama administration is hitting resistance from industry groups as it tries to change Medicare payments before leaving office. The administration argues its Medicare proposals will make payments smarter, save money and incentivize quality care. Opposition to the plans, it says, is mainly coming from entrenched interests that are seeking to protect their profits. But opponents say administration officials are overstepping their authority and rushing to make changes before the clock runs out. (Sullivan, 8/12)
More Tweaks Coming For Value-Based Medicare Advantage ProjectResearch, Data And Events
The federal government will expand a new Medicare Advantage program to three states in 2018, as part of an effort to change behaviors and cost-sharing for seniors who have chronic diseases. In addition, plans that want to join the Medicare Advantage Value-Based Insurance Design model can offer expanded benefits to two new types of chronically ill members, the CMS said Wednesday. (Herman, 8/11)