Medicaid Primary Care Parity

From Health Affairs:

For 2013 and 2014, the federal government raised payment rates to Medicaid primary care providers. Only some states plan to extend the rate increase.

Section 1202 of the Affordable Care Act (ACA) required states to raise
Medicaid primary care payment rates to Medicare levels in 2013 and 2014,
with the federal government paying 100 percent of the increase. This
provision–often referred to as “Medicaid primary care parity” or the
“Medicaid primary care fee bump”–was intended to encourage primary care
physicians to participate in Medicaid, particularly in the face of an
expected increase in enrollment as a result of the ACA’s expansion of
the program.

Federal lawmakers failed to reauthorize the fee bump during the 113th
Congress, ending in December 2014. As a result, states must decide
whether to revert to previous primary care payment levels or continue
at a higher level but without the benefit of the enhanced federal match.
Full details:
http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=137

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Bundled payments, new models of reimbursement, care transitions, value-based reimbursement, readmission penalties, are all part of the jargon in payer and provider circles today.

And there is no lack of opinions on what new or a combination of all is the answer to quality care, cost savings and outcomes results. All approaches come with some risks to providers and financially to payers.

On the eve of the new year, the Centers for Medicare & Medicaid Services (CMS) released the health care organizations selected to participate in  the Bundled Payments for Care Improvement initiative, an innovative new payment model.

“Under the Bundled Payments for Care Improvement initiative,” organizations will enter into payment arrangements that include financial and performance accountability for episodes of care. These models may lead to higher quality, more coordinated care at a lower cost to Medicare,” CMS said. Continue reading

What is Being Thrown into Your Healthcare Reimbursement Stew: All with a Goal of Care Improvement

Bundled payments, new models of reimbursement, care transitions, value-based reimbursement, readmission penalties, are all part of the jargon in payer and provider circles today.

And there is no lack of opinions on what new or a combination of all is the answer to quality care, cost savings and outcomes results. All approaches come with some risks to providers and financially to payers.

On the eve of the new year, the Centers for Medicare & Medicaid Services (CMS) released the health care organizations selected to participate in  the Bundled Payments for Care Improvement initiative, an innovative new payment model.

“Under the Bundled Payments for Care Improvement initiative,” organizations will enter into payment arrangements that include financial and performance accountability for episodes of care. These models may lead to higher quality, more coordinated care at a lower cost to Medicare,” CMS said. Continue reading

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