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Centene in the headlines: 5 updates in 30 days
Centene is one of the nation's largest health insurers by membership. -
National health spending has slowed since 2020, CMS report says
Despite an increased demand for patient care in 2021, national health spending growth has slowed to 4.6 percent compared to 9.7 percent in 2020, according to a CMS news release shared with Becker's. -
Florida physician gets 2 years in prison for fraud
Miami physician Mark Zager, MD, was sentenced to two years in prison for healthcare and wire fraud, the Justice Department said March 24. -
Insurer fined $339K after medical group, ASC contract termination
Health Care Service Corp., the parent company of BCBS of Illinois, was fined hundreds of thousands of dollars after terminating its contract with a 600-physician medical group and ASC. -
No winners, just losers and survivors amid payer issues
Healthcare is not a one-size-fits-all industry. The current and projected U.S. healthcare and other industries labor markets are experiencing labor shortages that are driving up wages for qualified workers. -
Anthem in the headlines: 7 updates from the last 30 days
Anthem is one of the largest health insurance companies in the country by revenue and membership. -
The payer trends impeding ASCs today
ASC owners and administrators are finding it more difficult to obtain payment from insurers as companies change coverage policies. But the current strain could push insurers and ASCs to find common ground on caring for the entire episode of care more efficiently and cost-effectively. -
$15B in cumulative savings for physician practices is on the table, study says
According to a study published in Health Affairs, if all physician practices performed at the level of "robust practices," they would save an estimated $14.9 billion on fee-for-service beneficiaries annually. -
Fee for service becoming a 'steady march to the bottom'; What's next for ASCs?
Physicians are clinging to fee-for-service payment to avoid the proverbial "race to the bottom" of bundled payments, which often cut pay rates. -
Medicare payments to ASCs drop 6.4%: 12 MedPAC report stats
Medicare payments to ASCs dropped 6.4 percent between 2019 and 2020, according to the Medicare Payment Advisory Commission's March report to Congress. -
Physician pay freeze should stay, says MedPAC
The Medicare Payment Advisory Commission recommended Medicare continue its physician fee payment freeze despite ongoing financial pressure from the pandemic. -
MedPAC recommends CMS slash ASC conversion factor in 2023
In its March report to Congress, the Medicare Payment Advisory Commission recommended cutting the 2023 Medicare conversion factor for ASCs and to require ASCs to report cost data. -
ASCs in the South earn the most revenue
Southern ASCs earn the most revenue in the country, according to VMG Health's "Multi-Specialty ASC Benchmarking Study" for 2022. -
'Rogue surgeon' seeks lawsuit dismissal; US attorneys say no
The U.S. attorney's office asked a federal judge not to dismiss a whistleblower lawsuit against the University of Pittsburgh Medical Center and one of its top surgeons, Pittsburgh Post-Gazette reported March 10. -
12 physicians sentenced to prison for $250M billing fraud
Twelve Michigan- and Ohio-based physicians were sentenced March 9 to prison for their roles in a scheme to perform and bill for unnecessary procedures in exchange for opioid prescriptions. -
Visa, Mastercard to hike merchant fees in April
Two major credit card companies plan to increase merchant fees, according to The Wall Street Journal. -
New York gastroenterologist pleads guilty to $3M billing fraud: 3 details
A gastroenterologist in Central Islip, N.Y., pleaded guilty March 7 to billing Medicare for millions of dollars for medical procedures that weren't performed, according to the Justice Department. -
Meet the all-cash ASC with over 10 years of price transparency success
The Surgery Center of Oklahoma in Oklahoma City is leading the charge in ASC price transparency with its all-cash model, according to a March 4 D Magazine report. -
55% of total collections at ASCs come from commercial payers
Commercial payers account for 55 percent of total collections at ASCs, according to VMG Health's "Multi-Specialty ASC Benchmarking Study" for 2022. -
How payer mix for ASCs stacks up
Commercial payers account for an average of 44 percent of total cases in ASCs, according to VMG Health's "Multi-Specialty ASC Benchmarking Study" for 2022.
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