Reimbursement Rates News

healthcare2 years ago•1 min saved

Navigating the Mercy/Anthem Dispute: Patient Advice

Mercy Health and Anthem have not reached an agreement on reimbursement rates, resulting in coverage at Mercy Health facilities becoming out-of-network for thousands of Ohioans, including retirees and Medicare-eligible seniors on the Anthem Medicare Advantage plan. Over 15,000 seniors in Mahoning and Trumbull County will be affected and may need to switch plans to continue using their preferred doctors and hospitals. Local Medicare brokers are available to help seniors explore their options and make informed decisions. In case of emergencies, Anthem Medicare Advantage members can still use Mercy Health hospitals.

via WKBN.com|

#anthem #healthcare #medicare-advantage

healthcare2 years ago•6 min saved

Medicare Reimbursements for Cataract Surgery Vary.

Medicare reimbursements fail to account for the increased time, resources, and effort required for complex cataract surgeries compared to simple cataract surgeries, potentially affecting doctors financially and reducing access to care for patients needing complex surgeries. Researchers used time-driven activity-based costing to measure the difference in day-of-surgery costs and net earnings between simple and complex cataract surgery and found that complex cataract surgery resulted in a financial loss of $646 compared to simple cataract surgery. The study highlights the need for more accurate reimbursement rates to ensure sustainable and equitable reimbursement for physicians and high-quality care for patients.

via Medical News Today|

#cataract-surgery #healthcare #healthcare-costs

healthcare2 years ago•2 min saved

Medicare Advantage Payment Cuts Softened and Delayed by CMS

The US government has announced a lower than expected 1.1% average cut of 2024 reimbursement rates for health insurers that offer coverage through the Medicare Advantage program, boosting shares of the market's largest players. The U.S. Centers for Medicare and Medicaid (CMS) said it expected total payments for next year to rise by 3.3% from 2023, or around $13.8 billion, up from its 1% initial estimate, and reduced drops on some costs resulting from rule changes. UnitedHealth Group Inc and Humana Inc shares were up more than 2% in after-market trade.

via Reuters|

#cms #health-insurers #healthcare

healthcare2 years ago•2 min saved

Medicare Advantage Payment Cuts Softened and Delayed by US Government

The US government has announced a lower than expected 1.1% average cut of 2024 reimbursement rates for health insurers that offer coverage through the Medicare Advantage program, boosting shares of the market's largest players. The U.S. Centers for Medicare and Medicaid (CMS) said it expected total payments for next year to rise by 3.3% from 2023, or around $13.8 billion, up from its 1% initial estimate, and reduced drops on some costs resulting from rule changes. UnitedHealth Group Inc and Humana Inc shares were up more than 2% in after-market trade.

via Yahoo! Voices|

#cms #health-insurers #healthcare