Managed Care Friday

Aug 12, 2022 | Managed Care Friday

70,000: The number of new healthcare jobs added in July, according to the Labor Department’s monthly job report, bringing the industry within 0.5% of its February 2020 employment level. In a sign of the way healthcare is moving, the majority of those jobs were in ambulatory services, ~47,000 compared to just 13,000 in hospitals. 9,000 new jobs were in nursing and residential care facilities. Drug Cost Sea Change: CivicaScript, part of a nonprofit launched by several health systems and 18 BCBS plans, launched its first drug this month, abiraterone, the generic form of Zytiga. Prostate cancer...

Weekly Medicaid Update

Aug 10, 2022 | Medicaid

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: MN: Rate increases for some HCBS providers serving disproportionate share of waiver enrollees MO: Rate increases for ASCs, dental services, PT/OT/ST services and more RI: State to allocate $20m in FY23 towards opioid prevention, treatment, and recovery Click to read more.

Managed Care Friday

Aug 5, 2022 | Managed Care Friday

$906: The average out-of-pocket cost for people with employer-sponsored insurance in 2019, compared to just $737 in 2013. A new analysis by the Employee Benefit Research Institute shows that the share of medical expenses paid by people enrolled in employer-sponsored coverage increased from 17.4% in 2013 to 19% in 2019. Out-of-pocket expenses dipped in 2020, probably due to the pandemic, but as these costs continue to rise, more and more insured patients are likely struggling to afford healthcare visits and procedures on top of their monthly premiums. This could lead to deferred care,...

Weekly Medicaid Update

Aug 3, 2022 | Medicaid

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: CT: Expands Medicaid postpartum coverage to 12-months IN: Makes changes to IP and OP hospital reimbursement OH: Senators introduce legislation for new dual eligible managed care program Click to read more.

FY 2023 SNF Final Rule

Aug 2, 2022 | Post-Acute Care, Skilled Nursing Facilities (SNF)

CMS Finalized FY23 SNF Payment Rates: CMS finalized payment policies changes that would result in an overall $904M increase in payments to SNFs for FY 2023. The increase is driven by market basket updates, offset by the first year of a required budget neutrality adjustment of -4.6% (-2.3% each year of a two-year parity phase-in) to account for overpayments from the transition to the Patient Driven Payment Model. Click to read more.