Tag: Medicare Spending

Site-neutral-A-solution-to-lower-healthcare-costs

How Implementing Site-Neutral Policies Can Help Reduce Healthcare Costs

The United States grapples with a healthcare affordability crisis, anticipating a 6.5 percent surge in costs due to inflation next year. Amidst concerns over escalating medical expenses, the deeper roots of these inflated prices often evade attention. Deficient government policies, notably Medicare reimbursement policies, contribute to consolidating the healthcare sector, ultimately driving up costs that […]
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How Medicare Out-of-Pocket Healthcare Spending Cap May Impact Beneficiaries

How Medicare Out-of-Pocket Healthcare Spending Cap May Impact Beneficiaries

A Medicare out-of-pocket healthcare spending cap could halve out-of-pocket spending for beneficiaries, but could boost overall traditional Medicare spending. By implementing a $5,000 spending cap in traditional Medicare, policymakers might be able to halve out-of-pocket healthcare spending for high-spending Medicare beneficiaries, but they risk an increase in overall Medicare spending, a study from Urban Institute […]
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No Surprises Act May Have Blocked 2M Surprise Billing Claims | AllZone Management Services Inc.

Healthcare spending could drop $11.4B next year if ACA premium subsidies expire, research finds

Healthcare spending could drop by more than $11.4 billion next year if enhanced premium tax credits enacted in the American Rescue Plan expire, new research finds. Hospital spending would decline by $3.8 billion, while spending on physician practice services would drop by $1.3 billion, according to a report from the Robert Wood Johnson Foundation and […]
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National Healthcare Spending May Grow 5% in the 2020s

From 2021 to 2030, national healthcare spending will return to its steady upward growth as the unusual impacts of the coronavirus pandemic dissipate. CMS has released its projections for national healthcare spending from 2021 to 2030, noting that healthcare as a share of the gross domestic product (GDP) will remain comparable to the share in […]
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National Healthcare Spending, Prices Saw Modest Increase in 2021

National healthcare spending increased by 3.4 percent in 2021, while the Health Care Price Index (HCPI) maintained a year-over-year growth of around 2 percent, according to Altarum’s February 2022 Health Sector Economic Indicators (HSEI) briefs. Unlike the December 2021 and January 2022 briefs, Altarum included federal government expenditures in the February data, which significantly impacted […]
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CMS Holding Claims Until Medicare Sequester Decision

CMS is temporarily holding claims from providers in anticipation of legislation that will extend the suspension of the 2 percent Medicare sequester, according to a recent newsletter. The MLN Connects newsletter from March 30 stated that CMS has “instructed the Medicare Administrative Contractors (MACs) to hold all claims with dates of service on or after April […]
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2021 Medicare Physician Payment Schedule

Final 2021 Medicare Pay Schedule: What Physicians Need to Know

The 2021 Medicare physician payment schedule finalized an AMA-developed approach for less burdensome coding and documenting of office and outpatient evaluation and management (E/M) services. The Centers for Medicare & Medicaid Services (CMS) also extended Medicare payment for many services delivered via telehealth at least until the end of calendar year 2021, but indicated that […]
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Telehealth Reimbursement Just for Value-Based Providers Post-COVID?

Telehealth reimbursement expansions granted during the PHE may be limited to providers in Advanced APMs moving forward to prevent program integrity issues, MedPAC said at a recent meeting. The Medicare Payment Advisory Commission (MedPAC) is the latest group to weigh telehealth reimbursement expansions after the COVID-19 pandemic. In a meeting held virtually last week, MedPAC analysts Ariel […]
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CMS Releases Long-Awaited 2021 FY IPPS Final Rule

Medicare spending on acute-care inpatient hospital services will increase by about $3.5 billion in FY 2021 As the healthcare industry continues to be buffeted by the unrelenting coronavirus pandemic, the Centers for Medicare & Medicaid Services (CMS) has released the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) final rule. The final […]
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2021 IPPS Proposed Rule: CMS Proposes Increased Payment Rates

According to the proposed rule, CMS projects total Medicare spending on inpatient hospital services, including capital, will increase by about $2.07 billion in FY 2021. CMS’ fiscal year (FY) 2021 Inpatient Prospective Payment System (IPPS) proposed rule, released May 11, includes a proposed increase to hospital payment rates, the creation of a new Medicare-Severity Diagnosis-Related Group […]
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