As we reported in our Managed Care Newsletter in April 2020, the CARES Act passed by Congress last year provides for a 20% increase to the DRG weights in the Medicare Inpatient Prospective Payment ...

Commercial insurers pay hospitals much more than Medicare in some areas than others, and a new study found that local market factors, including hospital dominance, help explain these growing price ...

Private insurers generally pay physicians higher rates than Medicare does for the same service but some specialties are winning out with significant commercial markups. Specialties such as cardiology ...

Allowed in-network charges for fixed-wing air ambulances rose 76% between 2017 and 2020, and now top $15,000, a new study by Fair Health found. The average charge rose 27.6% during the same time ...

Medicare's largest alternative payment model produced its highest annual savings to date in 2020, as shown by performance data released this week by the Centers for Medicare and Medicaid Services. The ...

Mean in-network commercial allowed amounts and charges per anesthesia conversion factor are 314% and 659% of traditional Medicare rates, respectively. Medicare Advantage payments align with ...

During the first six months of 2020, physicians reported $9.4 billion less in Medicare claims than expected at the start of the year, with spending down 19% as seniors deferred care during the ...

All but one of seven large commercial payers reported growth in their Medicare Advantage and other private Medicare membership in the third quarter of fiscal year 2019. Here’s how CVS Health-owned ...

At the start of the COVID-19 pandemic, Medicare spending on lab tests increased overall, despite spending for non-COVID-19 tests falling for the first time since 2016, according to the Office of the ...