Feb 21, 2023 | Medicare Advantage
The 2024 Medicare Advantage (MA) Advance Notice proposes changes to certain hierarchical condition categories (HCCs) that CMS considers to reflect discretionary diagnosis codes, including for diabetes (a common chronic condition) and protein calorie malnutrition (a more unusual condition among MA enrollees). Click to read more.
Feb 17, 2023 | Managed Care Friday
58,200: The number of healthcare jobs added in January, with ambulatory healthcare services seeing the biggest increase. Despite this, health systems and independent providers are still struggling with staff shortages. Henry Ford said they’ve hired back only about 25% of their nurses who left during the pandemic and a recent article in NPR highlighted the increased use of mid-level providers in ERs. But It’s A Match: The number of internal medicine doctor residency training positions has fluctuated over the last three decades but offered 9,380 in 2022, the highest on record with 95% of them...
Feb 16, 2023 | BRG Publications
The eighteenth edition of the Healthcare Payer Index tracks priorities from government sponsored and commercial payers, including self-insured employer plans, how they have changed over time, and what payers will focus on in the year ahead. This year’s Top 20 includes four services new to the rankings, five new entries in the Top 10, and a new number 1. Join BRG expert Bryan Cote as he discusses the Top 20 Payer Priorities for 2023 - what it all means, why it matters, and how to interpret the rankings for your business. Bryan will also discuss insights from our recently published Value-Based...
Feb 14, 2023 | Medicare Advantage, Part D
CMS recently released the 2024 Advance Notice of Methodological Changes for MA Capitation Rates and Part C and Part D Payment Policies, projecting a modest positive impact to MA payments overall, indicating a 1.03% revenue increase and a 2.09% effective growth rate. The Advance Notice outlines several updates to the Part C Risk Model, Star Rating regulations, and Part D benefit-related IRA amendments and additions. CMS also published the Risk Adjustment Data Validation (RADV) Program Final Rule which includes updates to audit methodology. Click to read more.
