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A bonus of up to 10 percent has been proposed for using an upgraded electronic health record (EHR) system for reporting in the Merit-based Incentive Payment System (MIPS) in 2018, but speakers at two recent industry conventions warned it’s likely not a worthwhile investment for providers.

When the previous administration at CMS finalized rules on mandatory bundled payment models for cardiac and orthopedic care late in 2016, 221 public comments were received. The cancellation of those same bundles, however, drew only 85 official comments as of Oct. 18.

Four accountable care organization (ACO) models generated more in gross savings in 2016, but unlike in previous years, CMS hasn’t publicly touted the results as it re-examines payment models created under the Centers for Medicare and Medicaid Innovation (CMMI).

The U.S. Department of Justice (DOJ) has abandoned a lawsuit against UnitedHealth over allegations the insurer submitted false claims in its Medicare Advantage plans, though a similar case remains active.

Private investors are becoming increasingly active in healthcare acquisitions, which may maximize the purchase price when practices decide to sell, but there are downsides to these transactions compared to be absorbed into a hospital or health system.

 

Recent Headlines

Aetna completely out of ACA exchanges for 2018

Making good on promises made by its CEO earlier this year, Aetna confirmed it will not offer policies on the Affordable Care Act (ACA) exchanges in any market for 2018. 

Clinicians can check 2017 MIPS participation status online

CMS has opened up a new online tool for clinicians to check whether they should participate in the new Merit-based Incentive Payment System (MIPS) for 2017.

Anthem wants 60 more days to fight Cigna’s exit from merger

Anthem has requested more time from a Delaware court to salvage its $54 billion merger with Cigna, asking for a 60-day extension of a temporary injunction to block its would-be partner from opting out of the deal. 

Billing patients at chargemaster rates may be illegal

Charging patients at the list prices for procedures and services set by the hospital chargemaster isn’t allowed under contract law, according to a study published in American Journal of Managed Care.

Siemens Healthineers looking at several separation options

Siemens is moving ahead with the planned split of its healthcare division, Siemens Healthineers, with CFO Ralf Thomas listing three options for the $15 billion business: a spinoff, an initial public offering or a reverse merger with a public company.

Anthem wants Supreme Court to review blocked Cigna deal

Anthem is taking its blocked $54 billion acquisition of Cigna to the U.S. Supreme Court, asking the highest court to review the rejection by a federal appeals court.

Q&A: AAFP's alternative payment model focuses on primary care

American Academy of Family Physicians (AAFP) President John Meigs Jr., MD, took a deeper dive with HealthExec into the new model, titled the Advanced Primary Care Alternative Payment Model (APC-APM), including what current APMs inspired its components and how it could help smaller primary care practices qualify for the 5 percent APM bonus.  

New Jersey’s Hackensack Meridian, JFK Health agree to merge

Hackensack Merdian Health would grow to a 15-hospital system in northern and central New Jersey under its new merger agreement with JFK Health.

1,600 Brigham and Women’s employees offered voluntary buyouts

Brigham and Women’s Hospital in Boston has presented 1,600 employees—nearly 9 percent of its workforce—with the option of a voluntary buyout as the hospital looks to cut costs.

CMS: Expect MIPS eligibility notices in next month

Clinicians should soon be receiving notices on whether they’ll be required to participate in the new Merit-based Incentive Payment System (MIPS), CMS said in a notice issued on April 25.

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