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DataGen analyzed the calendar year 2020 Medicare Outpatient Prospective Payment System final rule to show providers how Medicare outpatient fee-for-service payments will change from CY 2019 to CY 2020 based on the policies set forth in the CY 2020 OPPS final rule correction notice. In addition to the traditional impacts of marketbasket updates, etc., DataGen […]

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The year 2019 is beginning to wind down, but there’s no shortage of updates in bundled payments, policy and payment reform. Here’s what we found interesting in November—what’s been on your radar? Bundled payments The theory and thought behind bundled payments is that they are an effective way to improve care delivery and reduce costs, […]

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The Bundled Payments for Care Improvement Advanced program is about to enter its third year. As the program evolves, participants are eager to get a look at their reconciliation reports, which CMS began to release mid-November. The reconciliation results for performance period 1 span clinical episodes that started and ended between Oct. 1, 2018, and […]

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This month saw many policy updates and changes, as well as new reports on the progress of value-based initiatives. Here’s what we were thinking about this month—what caught your attention? CMS policy updates and changes With more demands piling on clinicians, the issue of physician burnout is becoming a big and costly issue. CMS released […]

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For this issue, we’ve brought together a lot of news about CMS initiatives and how various policies are impacting providers, payers and patients. These are what caught our attention this month—what’s on your mind? New from CMS CMS’ new Data at the Point of Care program has received a vote of confidence from the American […]

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CMS released five final rules for federal fiscal year 2020 and two proposed rules for calendar year 2020 that healthcare providers should note. The most significant is the Inpatient PPS final rule, which addresses the growing disparity between high and low wage-index hospitals. Under this policy, hospitals in the bottom quartile will receive an increase […]

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While many folks took some time off for vacation, the healthcare industry kept churning. It was a hot summer for news from CMS and we saw a number of responses from those impacted by proposed changes, new pilots and updated models. Here’s an end-of-summer recap. New from CMS: Technology pilot and proposed bundled payment models […]

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Here’s what caught our attention in July. What did we miss?   Downside risk and bundled payments CMS is pushing more payment models with risk but the proportion of accountable care organizations with downside risk has remained largely stagnant. On the rise: Reimbursement to doctors will increasingly be via bundled payments, ACOs, medical home models […]

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June saw several big conferences for our world — and also saw some interesting policy updates and decisions on key programs. Take a look below to learn more and let us know what caught your attention last month.   Social barriers to health America’s Health Insurance Plans held its annual meeting in June and announced […]

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Massive outpatient cuts inbound? DataGen has completed our analysis of the president’s recently-released 2020 budget proposal. This budget includes significant cuts that, if approved, would have major financial impacts on hospitals. These cuts include Outpatient Prospective Payment System site-neutral payment reductions. The FFY 2020 presidential budget proposed paying excepted sites at the physician office rate […]

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