In The News
During a meeting with reporters on May 22, 2019, Seema Verma,
Centers for Medicare & Medicaid Services
(CMS) Administrator,
stated
that she anticipates a proposed regulation to relax Stark Law restrictions to be published by the end of 2019. This is somewhat in contrast with the
2019 HHS spring regulatory agenda
, which
states
that the notice of proposed rulemaking for the revised Stark Law will be published in July 2019. As described in an
article
in the July 2018 Issue of
Health Capital Topics
, CMS issued a Request for Information (RFI) related to the regulatory burden of the Stark Law on June 25, 2018, and received
392 comments
.
The original purpose of the Stark Law was to regulate the referral of patients by providers to other providers with whom they have a financial relationship. However, with the U.S. healthcare delivery system’s shift toward value-based care, which utilizes payment models that incentivize those providers to provide a full continuum of care and manage costs, the referral incentive aspect is greatly reduced. As a result, many argue, the Stark Law’s application in the healthcare industry should be revised.
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On April 23, 2019, the
Centers for Medicare and Medicaid Services
(CMS) released their proposed rules for payment and policy updates for the Medicare
Inpatient Prospective Payment System
(IPPS) and the
Long-Term Care Hospital
(LTCH)
Prospective Payment System
(PPS) for fiscal year
2020. Other than the increase in IPPS and LTCH payments, the most notable portion of the proposed rule is the changes proposed by CMS to Medicare’s reimbursement of rural hospitals. This
Health Capital Topics
article discusses the various provisions set forth in the CMS proposed rule.
(Read more...)
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On April 22, 2019, the Secretary of the
U.S. Department of Health and Human Service
s (HHS), Alex Azar, and the Administrator for the
Centers of Medicare and Medicaid Services
(CMS), Seema Verma, announced a new system of payment models related to primary care reimbursement. The purpose of this new payment model system is to shift the focus of patient care from volume-based to value-based care, and to emphasize the importance of primary care’s role in the U.S. healthcare system. This new primary care initiative consists of two paths:
Primary Care First
(PCF) and
Direct Contracting
(DC).
(Read more...)
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Over the next few years, the smart glasses market “
is projected to witness a rapid growth
.” This technology may serve to solve a number of current issues in the healthcare delivery system, including ameliorating the physician manpower shortage and physician distribution problems (ultimately increasing patient access through virtual care), increasing safety and reducing errors, and decreasing training time. While the ultimate reach of these smart glasses innovations is still being determined, it appears from its growth to date, and the number of companies and collaborations offering such solutions, that this technology is not a passing phase, and may ultimately transform the healthcare industry.
(Read more...)
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The U.S. government is the largest payor of medical costs, through Medicare and Medicaid, and has a strong influence on healthcare reimbursement. In 2017, Medicare and Medicaid accounted for an estimated $705.9 billion and $581.9 billion in healthcare spending, respectively. The prevalence of these public payors in the healthcare marketplace often results in their acting as a price setter, and being used as a benchmark for private reimbursement rates. This is particularly true for
rural health clinics
(RHCs), which tend to serve a disproportionately large Medicare population. This third installment in the five-part
Health Capital Topics
series on RHCs will focus on the RHC reimbursement environment.
(Read more...)
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Advanced Distance Education to Launch in 2019
The
Institute for Healthcare Valuation
(IHV) &
Consultants' Training Institute
(CTI) are pleased to announce premier healthcare valuation training through a distance education program, the Certificate of Educational Achievement (CEA) for Advanced Education in Healthcare Valuation. The program will launch in 2019 and will bridge the interdisciplinary nature of healthcare valuation to include: the Four Pillars of Healthcare (regulatory, reimbursement, competition, and technology); the market forces shaping the U.S. healthcare industry; and the valuation of healthcare enterprises, assets, and services. Legal professionals and healthcare providers, as well as those wishing to expand their scope of activities in healthcare valuation engagements and those seeking to enhance their current healthcare valuation service lines, will gain comprehensive knowledge through completing the expansive program. The program has been developed and is being presented by industry thought leader
Health Capital Consultants
, alongside a blockbuster faculty of healthcare subject matter experts from the legal, federal regulatory, and valuation professions.
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