FY 2021 Proposed Rules for IPPS and LTCH

May 18, 2020 | Hospitals, Inpatient, LTCHs, Medicare

CMS has proposed FY 2021 rules for the hospital inpatient prospective payment system (IPPS) and Long-Term Care Hospitals (LTCHs), which will both be finalized at least 60 days prior to October 1, 2020 – likely the week ending in Friday, July 31, 2020. This brief summarizes the proposed changes made to the IPPS, which applies to approximately 3,200 acute care hospitals, and LTCHs, which applies to approximately 360 LTCHs. Click to read more.

Managed Care Friday

May 15, 2020 | Managed Care Friday

8 is Not Enough: An 8% reduction in chronic care condition downstream costs from frequent exercise among commercially insured has health plans seeing the potential of movement and many are creating new CEOs. Blue plan executives we chatted with this week say they are appointing chief exercise officers who will head up a range of initiatives following results of the new national study. Ideas floated in our poll: exercise breaks at a set time each day led by mix of celebrity instructors like Glee’s Sue Sylvester or using supplemental benefit Star bonus dollars for Medicare enrollees to build...

BRG Medicaid Update

May 13, 2020 | Medicaid

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: –   Florida: Additional flexibilities related to behavioral health services –   Massachusetts: Establishment of a new temporary CPT code for ABA services –   New York: Additional flexibilities for HCBS programs –   Ohio: Cuts to the Medicaid budget Click to read more.

Managed Care Friday

May 8, 2020 | Managed Care Friday

94: Percentage decline in screening appointments for breast cancer in March this year, compared to the last few years, according to data pulled by Epic. Komodo Health, which analyzed the billing records of 320 million patients across the country, found that screening for cervical cancer was down 68% from March 19 to April 20, compared to the previous 11 weeks and a comparable period last year. Tests for cholesterol, diabetes, and active and recurrent cancers were down, too, with the sharpest declines in geographic areas like New York and Massachusetts. Hard to See Bruising is Cancer Problem:...