The new rules will give providers in value-based arrangements greater certainty and ease the compliance burden for providers across the industry.
The proposed rules recognize that incentives are different in a healthcare system that pays for value rather than the volume of services provided.
Falls were the leading reason for readmission among patients whose initial hospital was fall-related and who were discharged to home, even with home care.
Private Medicare plans will soon include expanded plan options for seniors, more telehealth, and innovative plan designs and payment models.
New Discharge Planning Conditions of Participation require hospitals to assist patients, their families/caregivers in selecting a post-acute care provider.
Medicare Advantage (MA) Plans are adding two new dementia codes in their risk adjustment payment system and expanding flexibility in the MA benefit design.
A GAO report explored the efforts to manage high-expenditure beneficiaries, which are 5% of all Medicaid beneficiaries but nearly half of all expenditures.
A unified value-based incentive program for SNFs, home health services, inpatient rehabilitation facilities, and long-term care hospitals is recommended.
Why Do Providers Continue to Enter Into Business/Referral Relationships Without Meeting Applicable Requirements?
Why do providers continue to enter into business/referral relationships without meeting applicable requirements, thereby violating the law?
One of five people with self-care disabilities reported negative consequences from not having help with activities they had trouble performing on their own.