All Articles In 'Physicians'

Integrating Care for Medicare-Medicaid Dual Eligibles: A Primer for States

Integrating Care for Medicare-Medicaid Dual Eligibles: A Primer for States

Improving care integration for Medicare-Medicaid dual eligible beneficiaries is one of the many initiatives embedded in the Affordable Care Act (ACA). The health reform law created the Medicare-Medicaid Coordination Office at the Centers for Medicare and [...]

Health Care Price Transparency: Recommendations for State and Federal Government Actions

Health Care Price Transparency: Recommendations for State and Federal Government Actions

Price transparency – or making price information publicly available – is an idea that has gained steam recently as one more way to reduce health costs and improve quality. So far, that has taken the form [...]

Medicare Spending, Beneficiaries, Providers, Health Plans, and Drug Plans: MedPAC Data Book for 2013

Medicare Spending, Beneficiaries, Providers, Health Plans, and Drug Plans: MedPAC Data Book for 2013

Medicare will spend $598.4 billion on health care services for seniors and the disabled in 2013 and about $635 billion in 2014.  Medicare expenditures will top $1 trillion in 2021, according to CMS actuarial projections. Medicare [...]

Multi-Payor Medical Homes: Actions to Limit Anti-Trust Liability

Multi-Payor Medical Homes: Actions to Limit Anti-Trust Liability

Multi-payor medical home initiatives have many benefits. They can bring Medicare, Medicaid, and private health plans together to promote care coordination, better health outcomes, and lower costs. But they have one potential flaw: Allowing payors to coordinate [...]

Military Health Care: Health Professional Contracting and Coordination

Military Health Care: Health Professional Contracting and Coordination

The Department of Defense contracts with more than 11,000 health care professionals, at an annual cost of about $1 billion. A recent Government Accountability Office report says the military could do more to coordinate its contracting [...]

Medicaid Accountable Care Organizations: Provider Capabilities and State Supports

Medicaid Accountable Care Organizations: Provider Capabilities and State Supports

Though most commonly associated with Medicare, Accountable Care Organizations are now making their way into state Medicaid programs. Providers, of course, are an essential part of the ACO model. But many providers don’t yet have the [...]

Shared Savings: Most Popular Model, Best Practices for Accountable Care Organizations

Shared Savings: Most Popular Model, Best Practices for Accountable Care Organizations

Even as Accountable Care Organizations and other payment reform models become more common, there is still not much comprehensive information about which models providers participate in most often, and what exactly to do to make those [...]

Former Texas Medicaid Director’s Insights into Payment Reform

Former Texas Medicaid Director’s Insights into Payment Reform

Billy Millwee, former Texas Medicaid director, recently published an excellent piece with insight into that state’s experience with quality-based payment reform. Health care payors, both private and public, are looking more and more to tie payment [...]

Medicare Special Needs Plans: MedPAC Recommendations on Future of Special Needs Plans

Medicare Special Needs Plans: MedPAC Recommendations on Future of Special Needs Plans

Special Needs Plans (SNP) are part of the Medicare Advantage program and were created by the Medicare Modernization Act of 2003 (MMA). There are three types of SNPs, each intended to provide coordinated care for Medicare [...]

Compounded Drugs: Congress Takes an Interest in Growing Compound Drug Industry

Compounded Drugs: Congress Takes an Interest in Growing Compound Drug Industry

Compounded drugs are a new hot issue in the pharmaceuticals industry and in Congress. There are little data about compounding pharmacies, but a new Congressional Research Service brief gives a comprehensive overview. Compounded Drugs Personalize Drug [...]