Jan 7, 2022 | Managed Care Friday
131: Number of hours PA Lauren Valley worked at a busy urgent care clinic this past week in my town, often spending off time sleeping at the clinic, filling in for staff who were quarantined. Lauren is a terrific PA – smart, thoughtful, doesn’t just prescribe antibiotics and tests needlessly, calls the sinus issues the little kids have “boogies” but can adapt to help the older lady find her busstop after her appointment. There are thousands of Lauren Valley’s out there – but right about now, we need thousands more… DropOut: Cigna dropped Livongo from preferred status in its digital formulary...
Jan 5, 2022 | BRG Publications, Medicaid
BRG’s 2021 Medicaid Policy Review focuses on key drivers and areas of emphasis for states as we emerge from the pandemic-focused years of 2020 and 2021. The outlook reviews macro trends in enrollment and funding, provider rates, and state policies for people with mental illness and those with intellectual or developmental disabilities. Click to read more.
Dec 21, 2021 | Physician Fee Schedule, Physicians
Cardiology: Medicare FFS payments for cardiology, cardiac surgery, and pulmonary disease have fluctuated +/- 1 to 4% and spending has been largely flat in recent years. Medicare clinical labor reductions and changes to RVUs impact some codes. Click to read more.
Dec 21, 2021 | Physician Fee Schedule, Physicians
Optometry/Ophthalmology: Medicare FFS reimbursement for optometry and ophthalmology mixed in recent years. Program integrity activity for these specialties has become more common and is most often focused on Wet AMD drugs. Click to read more.
