HIT Consultant February 22, 2024
Don Rucker, MD – Chief Strategy Officer, 1upHealth

CMS and Medicare are trying to change the dynamics of American healthcare. No need to rehash the well-known issues but what is new is the change in the hotspot. For the last 20 years, Medicare Fee for Service has been the hotspot of spending and value. You’ve heard the mantra (which dates at least as far back as 1906 with George Bernard Shaw’s play, “The Doctor’s Dilemma”). If you pay a set rate the medical establishment has an incentive to increase volume. Now fast forward to today and Medicare Advantage has more beneficiaries. And the hotspot of healthcare economics has moved to Medicare Advantage (MA).

MA plans are paid by capitation for each patient. Now the incentive, or as...

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Topics: CMS, Govt Agencies, Health IT, HIE (Interoperability), Insurance, Medicare, Medicare Advantage, Provider, Technology
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