May 26, 2023 | Managed Care Friday
35: Percent of Americans who said their financial situation was worse in 2022 compared to 2021, which led to a higher number of people skipping medical treatment due to the cost, according to a Federal Reserve study. Only 75% of families with income under $25,000 reported being in good health, compared with 91% for those with income of $100,000 or more. People most often skipped the dentist, followed by seeing medical providers and filling prescriptions. Oh, The Worried Well: As Archie once said, ‘why do they always give me a shot where the pain ain’t…?’ It was classic Bunker, worried,...
May 25, 2023 | BRG Publications, Drugs
The Inflation Reduction Act’s drug pricing reforms headlined a flurry of drug-related policy activity over the last year. The action was not limited to Congress, as the Biden Administration took some Federal action to lower drug prices but held off on another, Federal courts decided cases centered on financial flows in the drug value chain, and states adopted interventions geared at lowering costs for patients. In this paper, BRG traverses the landscape of drug pricing reform efforts in 2022-23 and highlight what to watch in the coming year. Click to read more.
May 19, 2023 | Managed Care Friday
12,000: The number of people who called into the National Maternal Mental Health Hotline in its first 11 months. The hotline, launched on Mother’s Day in 2022, can be called or texted with any type of concern related to maternal health, and about 70% of contacts so far have been phone calls. The US has higher maternal mortality rates compared to other developed countries, and the hotline was launched as part of a broader effort to reduce these rates. New E&M Requirement: Effective May 25, Cigna will require that providers submit office notes for E&M claims 99212-99215 when...
May 16, 2023 | Medicare, Physician Fee Schedule
Recent Developments in Psychology, Psychiatry and Clinical Counseling: Psychiatrists benefited significantly from the 2021 office visit reimbursement increases. The other specialties saw more modest increases. Click here to read more.
May 16, 2023 | Medicare, Physician Fee Schedule
Recent Developments in Primary Care: PFS policy has been mostly positive for primary care specialties: family practice, general practice, internal medicine, and geriatrics. Click here to read more.
May 12, 2023 | Managed Care Friday
$114 Million: The amount L.A. Care Health Plan and Health Net will invest over the next several years to address the homelessness crisis in Los Angeles County. Due to the growing number of seniors and people with disabilities experiencing homelessness, the funding will be used to identify the daily living needs of unhoused people and connect them with caregiver help, along with securing leases on as many as 1,900 housing units and paying for things like vacancy coverage and trash services. Buckeye Health Decline: Ohioans have experienced a clear decrease in overall health, according to...
May 9, 2023 | Medicaid, Medicare, MedPAC
MedPAC: Assessing payment adequacy and updating mandated reports for Congress. MACPAC: Publishing reports on disclosure of nursing facility ownership, nursing facility payment data, and drug coverage. Click to read more.
