genie: all right nicolas germain, thank you so much, and doug herbert is welcome at thank you for urinalysis analysis will stop and out let's go to the analysis on iran for the nuclear program. it has been years in the making, but today could be the day that iran and powers come to a deal or lease the outline of a deal on the nuclear program. the goal is to stop iran from being able to fully develop a nuclear bomb. in return, the iranians want the crippling sanctions against unlisted. here is nicholas rushworth. nicholas: there are just hours now for iran and world powers to reach a framework agreement on iran's nuclear powers. >> negotiations will continue with great intensity. we sat together in talks throughout monday, but the truth is we are right now at a critical stage. we must continue to negotiate with great seriousness. nicholas: tehran is maintaining the suspense, saying it hopes to reveal at some point where we might reach agreement or it might be feasible, nevertheless we hope that maybe on tuesday or wednesday, a deal can be reached. nicholas: world powers want iran to scale bac

example would be if you go to a doctor for an office visit and some of the incidental lab work like urinalysisbut part of the payment that goes for the visit. bundled is a term used a lot and there are two different meanings. you can get very confused. i have been very confused about what people are talking about. it is used at the same way packaging is used. a whole bunch of services are bundled together into a single payment. that is the term used a lot in the dialysis where there has been a recent reform that instead of paying separately for the dialysis and then the drugs that the individual receives it's become a bundled payment or a packaged payment, a single payment with the drugs being included in that payment. it changes the incentive for how much drug you provide and that's a reason to package it or bundle it. the other meaning of bundled means putting different revenue streams together. money that goes to different providers, it can be a hospital and doctor we are now bundling that into a single payment that goes to one of the entities as a bundled payment or it can be -- we will ge

a simple example would be, you go to a doctor for a pame, and a urinalysis is not paid for, it is just payment that goes for the visit. "bundle" is a term that's used a lot. there are two different meanings for "bundled." i have been very confused what people are talking about. one is it is used in effect in a way that packaging is used. a whole bunch of services are bundled together in a single payment, and that's a term that's used a lot in adrenal disease where there has been a recent reform that instead of paying separately for the dialysis and then the drugs and then the treatment of the disease, it has become a bundle payment >> but there are per diems. there are episodes. so in home health we have switched to a system where the home health receives a payment for 60--- not fee-for-service, but a 60-day episode. and then finally, capitation, which the payment to medicare advantage. it is a fixed amount per month. it's the h.h.s. framework for traditional model. i'm going to switch to what was left in this legislation. i'm sure some of you were working with it. last year's was a su

you go to the doctor for an office visit and some of the incidental lab work like the urinalysis isn'tthat goes to the visit. it's used a lot and there are two different meanings in the bundling and you can get very confused. i've been a very confused about what people are talking about. one is that it is used at the same way the packaging is used. services are bundled together for the single payment and that is the term that is used a lot in the dialysis in the end stage renal disease where there has been a recent reform that instead of paying separately for the dialysis and then the drugs that the individual receives its become a bundled payment or a package payment, single payment with the drugs being included in the payment. it changes the incentive for how much drugs you provide and that is a reason to package or bundle it. the other meaning of bundled means putting different revenue streams together. money that goes to different providers that can be a hospital or dr. went out of bundling that into a single payment that goes to one of the entities as a bundled payment or we will