The CMS also wants to stop insurers from using expenses not directly related to quality improvement to inflate their MLRs. (Photo: Shutterstock) A proposed rule from the Centers for Medicare and Medicaid Services could change provider compensation and accelerate the adoption of value-based contracts , Modern Healthcare reported . […]
Provider bonuses included as incurred claims in insurers’ medical loss ratios must be explicitly tied to quality or clinical improvement standards under the December proposal. CMS also recommended that only spending directly related to quality improvement count toward insurers’ quality improvement claims in their ratio.