Jun 9, 2020 | ESRD, Medicaid, Medicare, Medicare Advantage, Part D
On May 22, 2020, CMS finalized policies affecting Medicare Advantage and Part D plans for the 2021 plan year—related to telehealth and network adequacy, beneficiaries with end-stage renal disease, and Star Ratings—while deferring some proposed policies to 2022, in recognition of the impact of COVID-19 in the near-term. Click to read more.
Jun 8, 2020 | Hospitals, Inpatient
In early March, at the outset of the COVID-19 pandemic, BRG’s Market Research team started tracking what payers, hospitals, physician groups, and consumers were thinking, and specifically how they saw themselves changing after the pandemic resolves. About 2,130 individuals with a stake in healthcare shared their views each month, and as March turned to April, and April to May, the more change seemed inevitable as a result of the crisis. In this Eye on Healthcare, we preview what 110 hospital and health system leaders have been experiencing and how they’ve responded. Their views may be a...
Jun 5, 2020 | Managed Care Friday
62: Percent of medical directors, out of 100, we polled who say they get pitched ‘all the time’ on value-based models or capitated payment concepts but often get rebuffed internally from the informatics or actuary team who ‘can’t figure out a way to code’ for the new model and handle all the claims. If there’s a lesson here, it’s that the medical director is important to get on board. You’ll need an ROI argument and a ‘time to ROI’, but ‘you’ll need to be prepared for pushback on how this can work administratively’. Concierge Surgery Benefit: Employer Direct Healthcare of Texas, a healthcare...
Jun 2, 2020 | ESRD, Hospitals, Medicare, Medicare Advantage, MedPAC, Outpatient
In its March and April 2020 public meetings, the Medicare Payment Advisory Commission (MedPAC) provided continuing coverage on the Medicare Shared Savings Program (MSSP), Medicare Advantage (MA), and analyzed select topics involving the ESRD and OPPS payment systems. Separately, MedPAC also released its March 2020 Report to Congress containing analyses of payment adequacy in FFS Medicare and the status of MA and Part D. Click to read more.
