The U.S. Centers for Medicare and Medicaid Services (CMS) recently released the capitation rates for hospice care through the value-based insurance design model (VBID), often referred to as the ...

Auditors say the increase coincided with an overall increase in Medicaid enrollment during the first year of the pandemic. The value of improper Medicaid capitation payments made by states to managed ...

Many healthcare delivery organizations have adopted some form of value-based payment model in recent years, shifting the healthcare focus from quantity of services to quality of outcomes. In a ...

MassHealth errantly paid more than $84 million related to care for residents who were living in other states, Auditor Diana DiZoglio’s office concluded in a new report that the executive branch ...

Established healthcare organizations, whether it be health systems, accountable care organizations, or independent provider groups often grapple with the dilemma of fully embracing risk. Fears of ...

A 13-year study of actual compensation amounts and rates paid to solo general dentists by a capitation or managed care type of insurance plan. The article first reports and then analyzes the ...

BOSTON, Mass. (SHNS)–MassHealth errantly paid more than $84 million related to care for residents who were living in other states, Auditor Diana DiZoglio’s office concluded in a new report that the ...

Historically, use of capitation for paying specialists lagged behind use of capitation for paying primary care physicians, with specialists primarily getting FFS payments, often with a discounted fee ...

In a unanimous decision filed Monday, November 20, 2023, the Minnesota Court of Appeals affirmed a district court opinion that limits medical assistance claims against estates to only the amount of ...