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Pay for quality in spotlight with new Medicare reimbursement rules: plans, states follow lead of updated Medicare no-payment policies.

Publication: Managed Healthcare Executive
Publication Date: 01-SEP-08
Format: Online
Delivery: Immediate Online Access
Full Article Title: Pay for quality in spotlight with new Medicare reimbursement rules: plans, states follow lead of updated Medicare no-payment policies.(NEW ANALYSIS)

Article Excerpt
NATIONAL REPORTS -- There is more focus today on linking payment with quality, whether as pay for performance, value-based purchasing or restructured employee benefits packages that modify out-of-pocket expenses based on quality of providers, say experts. This is why CMS's recently updated policy of refusing to reimburse for certain preventable events is top-of-mind for the industry.

"For some time now, the industry has been trying to satisfy two competing demands: employer demands for improved quality and reduced cost, and demands for plans to include a competitive network," says Leah F. Binder,...

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