Medicare primarily operates a fee-for-service (FFS) payment system. This means that healthcare professionals and facilities bill Medicare for each service they provide, with itemized costs appearing ...

Today’s payment models discourage quality improvement in healthcare and drive up costs for everyone, according to an analysis by David Bailey, MD, MBA, president and CEO of Jacksonville, Fla.-based ...

Among more than 3 million Medicare Advantage enrollees, value-based payment models outperformed fee-for-service models for all 15 clinical quality outcomes. The mean score differences for blood ...

CMS has been trying to scale value-based care for decades with mixed results — but the agency’s newly announced ACCESS model could represent a more meaningful step toward aligning payment with ...

The traditional fee-for-service (FFS) healthcare model isn’t well-suited to meet the complex needs of patients with chronic illnesses including chronic kidney disease (CKD). As costs spiral and ...

Previously, healthcare providers were reimbursed based on the volume of patients and services rendered, with less attention on outcomes. However, various initiatives introduced by CMS are driving the ...

Despite efforts to shift provider payment away from fee-for-service and toward more risk-based alternatives, fee-for-service remains dominant -- and is growing, according to a study published in ...

It’s March, which means one thing for sports fans: the madness of the NCAA men’s and women’s basketball tournaments. However, to folks in the regulatory world, it also means something else too: the ...

Policymakers are exploring reforms to address shortcomings of risk adjustment that inflate Medicare Advantage payments and ...

More than 1.3 billion adults globally will have diabetes by 2050, according to a study released this year. In the U.S., our current health system — which is structured around treatment, not prevention ...