Medicare and Medicaid Archives - Page 6 of 10 - BHM Healthcare Solutions Experts in Medicare and Medicaid

Insurance Markets Stabilization: Bipartisan Proposal From Governors

2017-09-05T18:02:22-04:00By Eric Duchinsky|Health Care Reform, Managed Care, Medicare and Medicaid, Taxes|

The governors John Kasich of Ohio, John Hickenlooper of Colorado, Brian Sandoval of Nevada, Tom Wolf of Pennsylvania, Bill Walker of Alaska, Terence R. McAuliffe of Virginia, John Bel Edwards of Louisiana, and Steve Bullock of Montana sent a letter to the Republican and Democratic leaders of the House and Senate asking them to take immediate steps to restore insurance markets stabilization structures. The letter was sent ahead of the testimony governors are expected to offer to the Senate Health, Education, Labor, and Pensions committee on September 7.

Health Insurance Tax (HIT) Impact on Medicare Plans: 2 Views

2017-08-30T18:00:35-04:00By Eric Duchinsky|Medicare and Medicaid, News and Events|

Sweeping repeal and replace legislation may be slowed, but does not mean significant healthcare changes are not coming off the legislative wish list. The debate on funding aspects of the healthcare law will likely continue through the 2018 election. The Health Insurance Tax (HIT) comes up for discussion and two organizations presented their takes on HIT's impact on Medicare programs and payers.

All-Payer Model Maryland Update: Care Redesign Program

2017-08-21T18:03:30-04:00By Eric Duchinsky|Financial, Medicare and Medicaid|

In July of 2017, CMS and Maryland continued their partnership and announced the Care Redesign Program (CRP). The CRP is a new voluntary program within the Maryland All-Payer Model that advances efforts to redesign and better coordinate care in Maryland. The CRP provides hospitals participating in the Maryland All-Payer Model the opportunity to partner with and provide incentives and resources to certain providers and suppliers in exchange for their performance of activities and processes that aim to improve quality of care and reduce the growth in total cost of care for Maryland Medicare beneficiaries.

CBO Report: Effects of Terminating Payments for CSRs

2017-08-17T00:13:48-04:00By Eric Duchinsky|Managed Care, Medicare and Medicaid|

The federal deficit would grow by $194 billion over 10 years if the Trump administration stops reimbursing private insurers for lowering out-of-pocket expenses for individuals under the Affordable Care Act (ACA), according to a report issued today by the Congressional Budget Office (CBO).

Medicare Advantage Projected Market Growth Creates Untapped Opportunities for Insurers

2017-08-15T21:28:11-04:00By Eric Duchinsky|Financial, Medicare and Medicaid|

Despite rapid-fire growth that has resulted in upwards of 33% of all Medicare beneficiaries now being enrolled in Medicare Advantage plans, few health plans are proactively marketing their offerings to consumers and all but a select few plans are falling short when it comes to successfully addressing provider integration and access to care for their members. Those are the key findings of the J.D. Power 2017 Medicare Advantage Study.

Medicaid Under-Utilization Group Demographics: Where’s Growth?

2017-08-08T22:51:46-04:00By Eric Duchinsky|Managed Care, Medicare and Medicaid|

Possible opportunities for growth, for payers and providers connected with the Medicaid systems in eligible states, exist in the continually low enrollments in Medicaid Savings Programs. The Medicaid under-utilization group demographics emerged through a recently released report from Medicaid and CHIP Payment and Access Commission (MACPAC).

Value Based Care Focus: The ACO

2017-07-05T15:12:32-04:00By BHM Marketing|Accountable Care Organizations, Health Care Reform, Medicare and Medicaid, Organizational Analysis, Strategic Planning|

The shift to accountable care and value based payment models is coming. Accountable Care Organizations (ACOs) are just one of the value-based models making waves throughout the healthcare industry. Based on current growth trends it is predicted by 2020 approximately 70 million people will be covered by ACOs. Focusing on shared accountability and quality improvement, ACOs have become champions of the healthcare triple aim. Not to mention a major player in CMS’ plan to tie a large percentage of payments to value by 2017. As ACOs soar in popularity now is the time to weigh your options. Are you are thinking or making the transition to an ACO? What are the benefits

Tough Decision: 68% Payment Now or Take a Chance on Appeal

2023-09-08T15:41:36-04:00By Eric Duchinsky|Medicare and Medicaid|

Last year, the Centers for Medicare & Medicaid Services (CMS) paid $1.5 billion in billing settlements to one third of the nation’s hospitals. Now, CMS has released who got paid what. According to Kaiser Health News (KHN), “the settlements were a compromise to reduce a swollen backlog of disputes over what hospitals argued they were owed¹.”

As Reported by Medicaid…

2023-09-08T15:10:18-04:00By Eric Duchinsky|Accountable Care Organizations, Medicare and Medicaid|

The shift to value based reimbursement has become inevitable, but Medicaid’s goal of tying 50 percent of all payments to value based initiatives by the end of 2016 may not be met. A recent survey by Health Catalyst shows that hospitals are slow to make the move towards value based initiatives. With only 3% of health systems currently meeting the target and 23% expected to meet the goal only by 2019.

Department of Health and Human Services Releases Final Rule on Managed Care in Medicaid & CHIP

2017-04-02T13:28:06-04:00By Eric Duchinsky|Managed Care, Medicare and Medicaid|

On April 26, 2016 the Department of Health and Human Services (HHS) announced the finalized version of a new rule on managed care in Medicaid and the Children’s Health Insurance Program (CHIP). The “rule advances delivery system reform, strengthens quality and consumer protections, promotes accountability, and aligns Medicaid managed care rules with other health insurance coverage programs.”

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