Medicare

CRISPR cancer trials
The Unique Struggle of Academic Medical Centers

No sector of the healthcare industry has been spared from the disruptive effects of healthcare reform over the past several years, but academic medical centers have often been singled out as particularly vulnerable to the nationwide changes in health delivery. Academic medical centers (AMCs) not only tend to serve high-need…

top hospitals by payor mix
GAO: CMS Bidding Program Cuts down on DME Fraud

A new report from the GAO found that CMS’ competitive bidding program for durable medical equipment (DME) may have unexpectedly cut down on device fraud and overutilization. The program was initially launched in 2007 to ensure that Medicare paid for medical supplies and devices at reasonable market rates, which was…

Mergers and Acquisitions
Bundled Payments: Tipping Point in Value-Based Care?

The Centers for Medicare and Medicaid Services’ (CMS) latest bundled payments proposal takes a bold step toward addressing Medicare payment reform for some of the most common, complicated, and costly care scenarios in U.S. healthcare. The Bundled Payments for Care Improvement (BPCI) program was launched in 2011 based on provisions…

Medical Imaging Providers Face Medicare Cuts for Failure to Comply with New Standards

Beginning on January 1, 2016, Medicare will reduce payments for certain Computed Tomography (CT) scans carried out by equipment that fails to meet standards defined by MITA, the Medical Imaging & Technology Alliance, an industry group that represents medical imaging technology manufacturers.  Reimbursement cuts will only impact the technical component…

CMS To Test Child HCAHPS

In 2015, CMS will begin exploring how parents and their children’s satisfaction with their care can impact into hospitals’ Medicaid and Children’s Health Insurance Program (CHIP) reimbursements. This is because CMS has begun using Child Hospital Consumer Assessments of Healthcare Providers and Systems (HCAPHS) surveys to track patient satisfaction in…

340B Drug Discount Program Under Scrutiny

A new study by Health Affairs has fueled controversy and raised further accusations that hospitals may be using the 340B discount drug program to boost profits instead of helping underinsured patients. The Health Affairs study, conducted by a professor at the University of Chicago and a director at the Memorial…

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