CMS--Engaging Multiple Payers in Payment Reform

Rajkumar, Rahul; Conway, Patrick H.; Tavenner, Marilyn
May 2014
JAMA: Journal of the American Medical Association;5/21/2014, Vol. 311 Issue 19, p1967
Academic Journal
The authors reflect on the move by the U.S. Centers for Medicare & Medicaid Services (CMS) to engage multiple payers in payment reform. They cite several initiatives taken by the CMS aimed at reducing program expenditures under Medicare, Medicaid, and the Children's Health Insurance Program (CHIP). They also describe a framework for understanding payment reform that classifies payment models base on the manner in which clinicians and health care organizations are paid.


Related Articles

  • front-line perspectives on price transparency and estimation. Workinger, Brian // hfm (Healthcare Financial Management);Sep2014, Vol. 68 Issue 9, p92 

    The article offers helpful pointers in improving price transparency and establishing consistent charges. Topics covered include giving estimates of charges to patients before providing health services, considering the charge data of the Centers for Medicare & Medicaid Services (CMS) and the...

  • Headaches On 'Close To' Therapy Change Remain.  // Eli's Rehab Report;Dec2012, Vol. 19 Issue 12, pp93 

    The article discusses the proposed change to the final rule of the prospective payment system of the U.S. Centers for Medicare and Medicaid Services (CMS) with regards to scheduling reassessment visits in multi-therapy cases. It notes the proposed revision of the regulations to clarify that...

  • What's Behind the SGR Formula? Froelich, John M.; Shah, Roshan P. // AAOS Now;Jul2012, Vol. 6 Issue 7, p22 

    The article focuses on the concept of sustainable growth rate (SGR) formula under the U.S. healthcare policy. It notes that the said formula is utilized by the U.S. Centers for Medicare and Medicaid Services (CMS) to manage spending by Medicare on physician services. It mentions that the formula...

  • If You Aren't E-Prescribing in 2011, You'll Face Cuts in Pay in 2012, CMS Says.  // Medicare Compliance & Reimbursement;1/17/2011, Vol. 37 Issue 1, p5 

    The article reports on the proposition of the Centers for Medicare and Medicade Services (CMS) to physicians to obtain an electronic prescribing plan in the U.S. It mentions that physicians who do not participate in electronic prescribing in 2011 can collect 1% less than the amount of the...

  • CMS Updates Practice Expense Rates. Addis, Leab // Review of Optometry;Dec2009, Vol. 146 Issue 12, p4 

    The article announces the implementation of practice expense rates in the U.S. Centers for Medicare and Medicaid Services' (CMS) Physician Fee Schedule (PFS). It anticipates that the 2010 Medicare PFS will increase payments to practitioners by five percent to eight percent. The American...

  • RACs Recovered $2.3 Billion in Fiscal Year 2012.  // For the Record (Great Valley Publishing Company, Inc.);May2014, Vol. 26 Issue 5, p32 

    The article discusses the release of the annual recovery audit contractor (RAC) of the Centers for Medicare & Medicaid Services (CMS) to the U.S. Congress which shows that RACs recovered in misused Medicare funds with $2.3 billion in fiscal year 2012.

  • CMS Slashes 2011 Conversion Factor by Over 30 Percent Vs. Current Rates.  // Family Practice Coding Alert;Nov2010, Vol. 12 Issue 11, p83 

    The article focuses on the move of the U.S. Centers for Medicare and Medicaid Services (CMS) to slash the physician's fee schedule conversion factor by over 30 percent compared to the existing rate of 38.8729 dollars. Based on the Fee Schedule of CMS, they are committed to reform the Medicare...

  • Proposed PPS rule one more burden for hospitals.  // AHA News;5/25/2009, Vol. 45 Issue 11, p1 

    The article reports on the $22 billion in proposed cuts to be implemented by the U.S. Centers for Medicare & Medicaid Services (CMA) as part of the 2010 inpatient prospective payment system (PPS) rule. In response, hospital leaders are planning to take advantage of the congressional recess to...

  • CMS issues interim outpatient regs.  // AHA News;1/12/2004, Vol. 40 Issue 1, p2 

    Focuses on the outpatient prospective payment system interim final regulation issued by the U.S. Centers for Medicare and Medicaid Services for 2004. Motivation for creating the rule; Details of the rule; Cost of changing the rule.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics