CMS to Launch New Direct-Contracting Pay Models in 2020

HHS on Monday launched an ambitious, double-pronged strategy to shift primary care from fee-for-service payments to a global fee model where clinicians and hospitals could assume varying amounts of risk.

U.S. Economic Burden of Chronic Diseases Tops $3.8 Trillion

The U.S. economic burden of chronic diseases such as Alzheimer's, diabetes, heart disease, obesity and cancer has reached about $3.8 trillion in direct and indirect costs—or nearly one-fifth of GDP, according to a new report from Fitch Solutions.

How One Doctor Changed the Way Patients Experience Care

Chronic diseases such as heart disease, diabetes, and hypertension are among the most preventable conditions. Lifestyle changes, evidence-based self-care and complementary approaches to healing can help patients manage these and other chronic conditions. It is the responsibility of their primary care physician to help support these changes.

CMS Expands Ability of MA Plans to Tackle Social Determinants of Health for the Chronically Ill

The policy change builds on previous efforts by CMS to encourage better management and maintenance of health by allowing increased flexibility for plan dollars to pay for services like adult care programs and the installation of home safety devices.

CMS: Physician Uptake of Advanced Payment Models Under MACRA Outpacing Goals

QPP includes two possible tracks for doctors, the Merit-based Incentive Payment System (MIPS) and the Advanced Alternative Payment Model. In 2017, more than 1 million doctors enrolled in MIPS, about 95% of those eligible, while more than 99,000 qualified for APM, which is a higher risk-bearing option, according to the report .

Codes Developed for Non-Face-to-Face Services

This article focuses on codes developed through the Current Procedural Terminology process with direction from CMS. Having CMS involvement was important to avoid the creation of “G” codes that many private payers do not cover. This did result in more complex codes that seem geared slightly toward the Medicare population.

1 in 5 Rural Hospitals at Risk of Closing, Navigant Says

Without some type of financial relief, as many as one in five rural hospitals in the U.S. could be forced to shut their doors, a new Navigant analysis finds. Of those, 64% are "highly essential" to the heath and economic well-being of their communities. In 31 states, at least half of at-risk rural hospitals are deemed essential.

Apple's Deal With the VA is a Big Step Toward Giving Patients Control Over Their own Health Information

Apple announced Monday that it's working with the U.S. Department of Veterans Affairs to bring health records to the iPhone. That means that vets receiving their care from the VA will be able to see medical information like allergies, immunizations, labs and procedures directly on their iPhones with just a few clicks.

Social Determinants of Health Impact Severity of Chronic Disease

New Jersey’s poorest zip codes have the highest rates of individuals with chronic diseases seeking care in emergency rooms, showing a strong link between the social determinants of health and poor outcomes, according to a new state report. The team from the Center for Health Analytics, Research and Transformation (CHART) at the New Jersey Hospital Association (NJHA) also found a clear relationship between employment status, income...