Many chronic illnesses and other health conditions—such as heart disease, cancer, multiple sclerosis, arthritis, diabetes, and emphysema—can result in functional limitations
Many states are enrolling Medicaid participants in capitated, risk-based managed care plans designed to coordinate all their care, including long-term services and supports
Government and providers of long-term services and supports (LTSS) use various approaches to promote service quality and protect consumers’ rights.
Nursing facilities provide long-term services and supports (LTSS), as well as short-term rehabilitation and postacute care following hospitalizations to people of all ages. Although younger p
A loophole in Medicare law related to hospital outpatient services (such as diagnostic tests, radiology, and certain surgeries) had subjected beneficiaries to much higher c
Traditional fee-for-service Medicare uses several payment systems to pay providers for services in the traditional program: prospective, episode-based, and
Medicare pays for hospital inpatient and outpatient services using a prospective payment system (PPS).
Medicare sets payment rates for physician services according to a fee schedule.
Under Part B, Medicare covers many types of medically necessary assistive technologies that improve health and functioning, including durable medical equip
Postacute care under Medicare refers to services provided after inpatient hospitalization or outpatient treatment.