Managed Care Friday

Sep 9, 2019 | Managed Care Friday

1.   Lyft In & Off:  The ROI on getting patients to appointments is so good that a network contracting team decided to hire rideshare company Lyft, even though industry commenters say Lyft does not have the same type of credentialing standards for drivers as traditional medical transport businesses (such as medical vans), according to a poll of our network operations managers. Some figured the ROI was good enough just to keep patients from using hospital ERs that they could worry about consequences later, like a lawsuit because the driver isn’t vetted and gets in an accident. Other...

CMS Proposes Modest Changes to CY2020 DME Payments

Sep 4, 2019 | DMEPOS, Medicare

With competitive bidding Round 2021 already underway, the CY2020 proposed rule for Durable Medical Equipment would make relatively minor changes to pricing for new DME items on the fee schedule. It would also make changes to the eligibility process for DME items potentially subject to prior authorization or face-to-face encounter requirements. Click to read more.

Managed Care Friday

Aug 30, 2019 | Managed Care Friday

1.   No House of Cards: Health plans are continuing to act on the link between stable housing and better health. Illinois’ Blue plan recently invested in housing to improve the health of homeless Chicagoans by partnering with private and public funders, investing as much as $1M in the project in Chicago’s Flexible Housing Pool. The two-year grant will fund housing, paired with intensive case management services, for people who are homeless and have been frequent visitors to hospital emergency rooms. The city of Chicago aims to host 750 units of supportive housing in the future. United...