On April 22, U.S. Department of Health and Human Services (HHS) officials announced the introduction of five optional value-based care models for large and small primary care physician practices. The new payment models will incorporate incentives for keeping Medicare patients healthy, as alternatives to traditional fee-for-service payment structures.

Alex Azar, HHS Secretary, and Seema Verma,

On April 5, the Centers for Medicare & Medicaid Services (CMS) issued a final rule (CMS-4185-F) that updates the Medicare Advantage (MA or Part C) and Medicare Prescription Drug Benefit (Part D) programs by promoting innovative plan designs, improved quality, and choices for patients.

The final rule will increase MA plan choices for the 2019

New York’s state budget for the 2019-2020 fiscal year, approved by the State Legislature on March 31, included provisions that codify into state law the primary consumer protections of the federal Affordable Care Act. In a public announcement, Gov. Andrew Cuomo said, “We have codified many of the protections of Obamacare, so regardless of what

On March 27, the Innovation Center at the Centers for Medicare & Medicaid Services (CMS) announced an artificial intelligence contest. The CMS Artificial Intelligence (AI) Health Outcomes Challenge, in collaboration with the American Academy of Family Physicians and the Laura and John Arnold Foundation, is looking for innovative technology and strategies to predict health outcomes,

A three-month joint investigation of electronic health records (EHR) systems has culminated in a release of a March 18 article in Kaiser Health News (KHN) and Fortune Magazine, “Death By 1,000 Clicks: Where Electronic Health Records Went Wrong.” The lengthy, meticulously sourced article calls EHR systems “an unholy mess.”

KHN and Fortune have made the

The World Health Organization (WHO) defines social determinants of health (SDOH) as the conditions in which people are born, grow, live, work and age that are primarily responsible for differences in health status. Rivkin Radler’s Robert Iseman recently penned a Thought Leaders’ Corner column for Population Health News in which he made suggestions regarding how healthcare organizations

At the Federation of American Hospitals’ 2019 Public Policy Conference on March 4, Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma announced the agency’s plan to make dramatic changes to the federal physician self-referral prohibition, commonly known as the Stark Law. The changes are designed to support a value-based model of care in

Yesterday’s Rivkin Rounds post discussed the Proposed Rule on information blocking recently released by the Office of the National Coordinator for Health Information Technology (ONC). The Centers for Medicare & Medicaid Services (CMS) simultaneously released its own 251-page Proposed Rule, addressing some of the same concerns but focused on interoperability and patients’ access to their

On February 6, the U.S. Department of Justice announced that Greenway Health LLC, a Florida-based developer of electronic health records (EHR) software, will pay $57.25 million as part of a False Claims Act settlement. The United States had alleged that Greenway misrepresented the capabilities of its software product, called “Prime Suite,” causing healthcare providers to submit

On January 28, the Centers for Medicare & Medicaid Services (CMS) announced the launch of a new mobile app called “What’s Covered” to help consumers understand which items and services are covered by Medicare. The app is part of the eMedicare Initiative, launched in October 2018 to modernize the delivery of information about the program.