Mar 2, 2018 | Managed Care Friday
1. 3.6 Million: Number of Americans who miss medical appointments due to a lack of reliable transportation, which evidently lead to the launch yesterday of Uber’s new business called “Uber Health”, according to an Uber general manager. Uber Health will provide a car service platform specifically to drive patients to hospitals and rehab centers, allowing medical facilities to book rides using a web dashboard. 2. Marriage, Is What Brings Us Together…Today: Licensed psychologists and marriage and family therapists are being invited, as of this month, to participate in BCBS of Michigan’s...
Mar 1, 2018 | Medicaid, Medicare
The CMS Innovation Center tests innovative health care payment and service delivery models that have the potential to lower Medicare and Medicaid program expenditures while maintaining or enhancing the quality of care. Although the Trump Administration has shifted to more voluntary – rather than mandatory – participation in demonstration programs, the Innovation Center remains an important tool for testing delivery system reforms in both fee-for-service and managed Medicaid and Medicare.Click to read more.
Feb 28, 2018 | Legislation/ Budgets/ Macro
This brief provides an overview of current and future oversight activity by the OIG and GAO within the healthcare industry, including a summary of 2017 activity, expected trends for oversight in 2018, and a summary of 2018 enforcement actions to date.Click to read more.
Feb 26, 2018 | Medicaid, Medicaid Managed Care
In January, the Medicaid and CHIP Payment and Access Commission (MACPAC) approved a recommendation that would facilitate states’ ability to mandate managed care enrollment for certain vulnerable populations. The Commission also examined Virginia’s recent substance use disorder residential treatment waiver and discussed the need for more information related to the IMD exclusion. A framework behind Medicaid hospital payment was proposed and the HHS Secretary’s report on the Money Follows the Person Demonstration (MFP) was reviewed.Click to read more.
Feb 22, 2018 | Drugs, Legislation/ Budgets/ Macro
On February 19, the Trump administration released its budget plan for 2019. The individual parts of White House budget proposals – which comprise a kitchen sink of administration philosophy, longstanding policy ideas, MedPAC and OIG recommendations, etc. – often serve as a go-to source for Congress when pay-fors and policy ideas are needed for actual Medicare reforms. This makes them worth paying attention to. Click to read more.
Feb 20, 2018 | Hospitals, LTCHs
BRG Managing Director Greg Russo and Senior Managing Consultant Mandy Asgeirsson published an article analyzing long-term care hospitals (LTCHs) and the impact that recent payment changes will have on the industry. Medicare spending for care rendered in LTCHs rose by approximately 50% between 2004 and 2013. To control costs, the federal government passed the Pathway for SGR Reform Act of 2013. In this paper, the authors model the revenue impact that this bill will have on LTCHs as it becomes fully implemented. Click to read more.
Feb 17, 2018 | Behavioral
A recent report by the Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC) finds that 4% of adult Americans are diagnosed with a serious mental illness (SMI) and 7%-12% of youths with a serious emotional disturbance (SED). Effective treatments exist, yet they are seriously underutilized. Over the next five years, the ISMICC will evaluate current federal programs and implement recommendations put forth by the non-federal members of the ISMICC. Click to read more.
Feb 14, 2018 | MedPAC, Physicians
As the new MACRA-created MIPS program goes into effect, some physicians and MedPAC have raised concerns. Issues range from uncertainty about who is required to report to the inclusion of Part B drugs. MedPAC even got in the mix with a last minute proposal to scrap the new program altogether. Click to read more.
Feb 13, 2018 | Hospitals, MedPAC
At MedPAC’s January meeting, the commission discussed a study mandated by 21st Century Cures legislation on the hospital readmissions reduction program (HRRP) to be included in the June report to Congress. MedPAC found that the HRRP has successfully created an incentive to reduce hospital readmission rates while demonstrating that program efforts do not negatively impact mortality rates. MedPAC made recommendations on ways to improve the HRRP, which it aims to include in the June 2018 report to Congress. Click to read more.
