Value Based Insurance Design New Clinical Categories for MA Plans

The Centers for Medicare & Medicaid Services (CMS) is announcing refinements to the Medicare Advantage Value-Based Insurance Design (MA-VBID) model. Beginning January 1, 2018, CMS will add rheumatoid arthritis and dementia…

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CMS Merit Based Incentive Payment System (MIPS) in 60 Day Comment Period, Sunsetting of Meaningful Use

New Federal healthcare industry payment models, based on the April 27th release of a proposed rule, present MIPS, MACRA, and APM methods for calculating healthcare reimbursement. The document proposes once…

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Drug Pricing Legislation and Inefficient Markets Theory

The inefficient markets theory is being reconsidered after the 2007 financial crisis in the U.S. Is it enough to provide the public with data on the cost of a service or alternative ways to purchase it? In healthcare the intersection of price, quality and sources of suppliers alone does not determine whether pricing is appropriate.

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Value Based Care Regulations Yield Physician Discontent, No Change in Behavior

Clinicians are in a knowledge management crisis – massive amounts of data but getting the right information to clinicians, IT personnel and others at the right time is the challenge. What was missing from the RAND report were biomedical informatics perspectives.

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