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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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CMS has proposed five new Medicare Prospective Payment System rules for federal fiscal year 2020 that healthcare providers should understand. The most significant of these proposed rules is in the Inpatient PPS proposed rule, which seeks to address the growing disparity between high and low wage index hospitals. This provocative proposal calls for hospitals in […]

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At DataGen, the month of May has been all about prepping for Model Year 3 of the Bundled Payments for Care Improvement Advanced program. But that doesn’t mean the rest of the healthcare industry is taking a breath. Here’s what caught our eyes in the news in May. Where was your attention focused on last […]

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Setting your organization up for success With the application deadline for the Bundled Payments for Care Improvement Advanced model year 3 looming, new and returning applicants are actively preparing themselves for success in the program. That success can be a daunting proposition—choosing the right episode types, knowing your average episode costs, and getting the right […]

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The Data-Driven Mindset As any bundled payment program veteran can tell you: you can’t do well in one of these programs if you’re not willing to make some changes to how you manage care. To maximize bundled payment savings, participants must base their decisions on data. This data-driven mindset should be at the core of […]

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The application period for model year 3 (MY3) of the Bundled Payments for Care Improvements Advanced program will close on June 24. Doing well demands a deep understanding of the program’s nuances—we can help. Aveus, a division of Medecision, is joining DataGen in hosting one-on-one consulting sessions to provide assistance as you consider applying. These 30 minute […]

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