Feb 5, 2018 | MedPAC, Physicians
MedPAC annually reviews Medicare payment policies and makes recommendations to Congress. In this brief, we highlight MedPAC’s assessment of Medicare payments to physicians and other health professional services along with the commission’s recommendation to repeal the Merit-based Incentive Payment System (MIPS) and replace it with a Voluntary Value Program (VVP). Click to read more.
Feb 1, 2018 | Commercial Insurance, Medicare, Physician Fee Schedule
BRG analysis of Truven data found that commercial telehealth utilization grew from 2014 to 2016. While this growth was seen across service types, it was most significant in physician services. Geographic variation in utilization was observed, with the highest rates in Delaware, followed by New Mexico. Government payers are emphasizing telehealth as well, with expansions to Medicaid coverage, the recently passed VETS Act, and monthly MedPAC meetings in advance of a mandated telehealth report due to Congress in March.Click to read more.
Jan 31, 2018 | Medicaid, Medicaid Managed Care, Medicare
Beneficiaries eligible for both Medicare and Medicaid (i.e. dual eligibles) are among the highest-cost enrollees in both programs, and Federal and state policymakers continue to attempt to find ways to better coordinate care and control costs. In its sixth year of operation, the Financial Alignment Initiative has operated in 13 states, testing a model to improve beneficiary quality and access to care, while reducing spending for public programs. Given the high cost and complexity of this population, any program shown to reduce utilization and spending while maintaining or increasing enrollee...
Jan 30, 2018 | Medicare Advantage
Special Needs Plans (SNPs) are distinct from other Medicare Advantage (MA) plans in that only certain beneficiaries are eligible to enroll. Originally authorized in 2003 as a temporary program to encourage innovation in MA, SNPs have since been continually extended by Congress. The SNP program was designed to provide targeted care to high-need and high-cost Medicare beneficiaries, and beneficiaries can enroll or disenroll year-round, unlike enrollees in most other MA plans. Several recent trends and proposed changes affect the SNP model and may pose risks or opportunities. Click to read...
Jan 29, 2018 | Medicare Advantage
In the coming week, we expect CMS to release its Medicare Advantage (MA) Advance Notice for plan year 2019. In this brief, we will discuss the main topics included within the release and reference recent developments within MA. Click to read more.
