Managed Care Friday

Apr 9, 2021 | Managed Care Friday

42: The number that hangs from baseball’s rafters and now also the percentage reduction in the rate of asthma-related emergency department visits and hospitalizations, thanks to a collaboration between health insurer HCSC and the American Lung Association. The project, Enhancing Care for Children with Asthma, launched 9 years ago and works with community clinics across the insurer’s 5 states to implement a quality improvement program to support asthma management in children. Devising An Outcomes Contract: Spectrum Health, the integrated health system in Michigan, is entering into a...

DRA 2% Medicare Sequestration Suspension Extended For All CY21

Apr 8, 2021 | Medicare

Congress is in the process of suspending the 2% Medicare sequestration imposed by the Deficit Reduction Act of 2011 for the remainder of CY2021. Additionally, the 4% sequestration scheduled for 2022 by the Statutory Pay-As-You-Go Act of 2010 is likely to be waived prior to implementation. Click to read more.

Weekly Medicaid Update

Apr 7, 2021 | Medicaid

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: ·       MN: 10% rate increase for outpatient services under SUD waiver ·       NY:  Governor signs FY21-22 budget ·       OH:  State selects MCO for children with complex behavioral health needs ·       TX:   State’s OIG opens investigations on four dental providers based on billing patterns Click to read more.

BRG Quarterly Compliance and Program Integrity Developments

Apr 6, 2021 | Legislation/ Budgets/ Macro

The BRG Healthcare Transactions and Strategy quarterly compliance bulletin compiles noteworthy developments in the healthcare sector related to compliance, program integrity, and enforcement activities. In the first quarter of 2021, we have taken particular note of: ·       DOJ/HHS activity ·       Two OIG reports ·       Two Comparative Billing Reports ·       Four GAO reports ·       OCR activity ·       Proposed and approved additions to the RAC audit list Click to read more.

Managed Care Friday

Apr 2, 2021 | Managed Care Friday

5G: Vitas Healthcare, a hospice and palliative care provider, is working with AT&T to test whether virtual reality delivered through a 5G network can help reduce pain and anxiety for patients receiving end-of-life care. Large institutions like USC, Spectrum Health, Emory and the VA have all launched programs utilizing 5G in unique ways to try to better patient care. Value Contracts: 79 health plan payment innovation directors out of 100 we polled last month say they are building out condition-based episodic structures that will be the same across patient populations – commercial,...