Healthcare payment predictions for 2022

Being able to settle bills anytime, anywhere, is one of the reasons why 110 million Americans switched to “digital-first” payment methods last year. Today’s consumers can pay household bills with their mobile devices while cooking dinner or waiting in the school pick-up line. They can pay for their morning coffee by tapping their phone at …

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Specialty physicians in Connecticut gain path to value-based care, payment boost via private health plan

The State of Connecticut Health Plan is the first commercial plan in the country to have its episodes-of-care payment model designated as an Advanced APM by CMS. This will provide specialty physicians in the state a path to value-based care payments through the private sector, as their Advanced APM options via CMS are limited.

OIG: MA companies used chart reviews, health risk assessments to boost CMS payments

Overall, MA companies generated an estimated $9.2 billion in risk-adjusted payments for diagnoses listed only on chart reviews and health risk assessments, with the top 20 companies receiving more than half of the payments. OIG is urging CMS to provide more oversight.

CMS repeals MA rate disclosure requirement, boosts hospital payments by $2.3B

CMS has finalized its 2022 inpatient payment rule, which will not only repeal part of the price transparency requirements related to Medicare Advantage rates and increase payments to hospitals but will also require facilities to report Covid-19 vaccination uptake among its employees.

Effort underway to help hospitals by suspending Medicare sequestration

Medicare sequestration is making headlines this week, as legislation to pause the 2% payment cuts moves through Congress. Here is a recap of what the sequester cuts are, why hospitals want it gone and how lawmakers are working to make that happen.

Simpler bills, more payment options can improve hospital billing experience

A new survey from healthcare revenue cycle firm Waystar shows that most patients find their medical bills confusing and delay payment because of financial constraints. But there are steps hospitals can take to improve the billing experience for patients.