Category Archives: Uncategorized

NC Changing Medicaid Methodologies to Get More Predictable Spend Along w/Better Quality of Care

In an ever-changing sign of the times away from fee for service (FFS) payment models, NC has announced its intention to move away from FFS and to a blend of managed care and ACOs to help lawmakers come up with a more predictable way to measure Medicaid expenditures.  Will other states follow?

Read more here.

New Twist to New ICD-10 Related Legislation Just Introduced: 2 Year Grace Period

There was yet another loud collective groan heard around the country last week when word got out that another anti-ICD-10 bill was introduced in Congress, this time by the Alabama delegation.  After pulling back the covers a bit, this bill is different from the ones previously introduced; it calls for a 2 year grace period on the implementation of it but doesn’t specifically call for a delay.

Read more here.

Breaking News: CMS Chief Marilyn Tavenner to Step Down

Last Friday it was announced the current head of CMS Marilyn Tavenner is to resign at the end of February.  By all indications, she had bipartisan support from both sides of the aisle but she seems to have been caught up in the politics surrounding the troubled rollout back in October of 2013.

CMS’ #2 administrator Andrew Slavitt is slated to step in until a replacement is found and undergoes the confirmation process.


Population Health is Evolving in the Ever-Evolving Healthcare Landscape

With the changing healthcare environment, the traditional silos of the healthcare system (e.g. payers vs. providers) no longer works.  Whether these two typically opposing entities like it or not, they have to come together in order for the common goals of better healthcare and health outcomes along w/better quality and cost controls for everyone.  As we all live longer and have to deal with more chronic versus acute conditions, payers and providers have had to ramp up their respective population health programs.  In the past, it has been seen more from their particular vantage points from the payer/provider lens, but increasingly in shared-savings arrangements and landscape such as ACOs and Patient-Centered Medical Homes, these walls are coming down.  Read here how some of this is happening.