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There is still plenty of room for improvement, according to the AAA. The CLASS Act doesn't include sufficient funding to market the program, meaning participation will be low - the CBO says 5% of the population would sign up, the CMS actuary says 2.5%, and AAA says 6%. Such low participation would not allow risk to be spread out enough to keep premiums affordable; in that case, the program could end up in an "insurance death spiral," in which premiums are so high, only those who know they'll need coverage sign up, driving up premiums even further until they...
...when the princess wore ballet flats to a royal audience with students this summer, the gossip magazine Hola put the story at the top of its website. Whether her affection for the high heel is a fashion preference, or a necessity dictated by her husband's 6' 5.5" (197 cms) height, remains a state secret...
Congress and the Centers for Medicare and Medicaid Services (CMS) have taken steps to rein in imaging. Beginning next year, imaging centers will see payment cuts that the industry and its manufacturing allies--GE, Siemens, Phillips--say will reduce some payments to 20% of the cost of doing them. To level the specialty-hospital playing field, CMS will pay hospitals more for their more complex cases. Similarly it proposes to pay ASCs at 62% the rate of hospital outpatient departments. The industry is asking for 75%. Lobbyists are racing to the scene...
Further, since physicians get paid through fee-for-service rather than, say, for curing their patients, their primary incentive is to do more stuff. CMS is starting to experiment with pay-for-performance programs that address this concern. But such measures can work only if they are remunerative enough to counter the base incentives that drive excess care. "A few pennies here and there is not going to change what physicians do every day," says Pham. "They're not stupid, and they have business managers...
...Five CMS players, including Nick Shannahan and Colin Reed, whose scores of 78 tied for second-best, finished in the top six overall...