Many healthcare delivery organizations have adopted some form of value-based payment model in recent years, shifting the healthcare focus from quantity of services to quality of outcomes. In a ...

The Centers for Medicare & Medicaid Services Sept. 30 released guidance to states clarifying its interpretation of a provision that authorizes federal financing to pay for emergency Medicaid ...

It’s happening in different ways and different places around the country, but, broadly speaking, healthcare payors are starting to move away from traditional fee-for-service payment models. Providers, ...

Why are ACOs so important to CMS?Many observers believe that CMS’s ultimate goal in healthcare reform is to pay for covered services at capitated rates that are just high enough to assure adequate ...

Medicare Advantage, also known as MA or Medicare Part C, is a privately administered insurance program using a capitated payment structure, rather than fee-for-service (FFS) structure of Traditional ...

Veterans with VA benefits are enrolling in MA plans, raising concerns about duplicative federal spending due to substantial capitated payments. A study found no significant differences in dental and ...

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 ...

BOSTON — Confronting soaring health care costs compounded by widespread obstacles in accessing care, top insurance executives warned Thursday that the state's health care system is at a breaking point ...