Sep 20, 2022 | Legislation/ Budgets/ Macro, Medicare
Surprise Billing Final Rule Released: No Surprises Act final rule was revised after litigation providing a modest improvement for providers, total impact of federal regulation of certain out-of-network billing remains a net negative for certain physician specialties. Click to read more.
Sep 16, 2022 | Managed Care Friday
$43.9b: The amount spent on outpatient drugs through the 340B program in 2021, according to a new government breakdown of spending. Disproportionate share hospitals are the largest purchaser of 340B drugs by far, followed by children’s hospitals, rural referral centers, and Ryan White programs. The difference between list prices for drugs and discounted 340B purchases grew to $49.7b, per Drug Channels. Mind Games: A collaboration between Highmark Wholecare, the health plan’s Medicaid and Medicare division, and Posit Science aims to utilize brain training software to prevent falls. By...
Sep 13, 2022 | Medicare, Physician Fee Schedule
Rheumatology: Recent developments in rheumatology includes mixed Medicare FFS reimbursement trends and fluctuating Medicare spending. Click to read more.
Sep 13, 2022 | Medicare, Physician Fee Schedule
Dermatology: Recent developments in dermatology includes mixed Medicare FFS reimbursement trends and stable Medicare spending. Click to read more.
Sep 9, 2022 | Autism, BRG Conference Call Replays
BRG experts Misha Segal and Jim Teisl, with guests Mai Pham, Founder and President of Institute for Exceptional Care, and Lorri Unumb, CEO of The Council of Autism Service Providers, discuss the rapid growth in autism services and the recent debate surrounding types of treatment and standards of practice. Panelists also touch on lessons learned for other evolving areas, including medication-assisted therapy, outpatient mental health, residential treatment services, and home and community-based services. Click here for the recording (if asked, use passcode KJ%^C+w3) Autism Providers Face...
Sep 9, 2022 | Managed Care Friday
22.2: Cents of every insurance premium dollar spent in 2020 went to prescription drugs, up from 21.5 cents in 2018, according to a recent analysis of commercial insurance claims from AHIP. Spending on hospital inpatient and outpatient costs held steady compared to 2018, making up a combined 38.9 cents of every dollar, while other medical costs, like physician office visits and ER trips, made up 21 cents on the dollar and the rest went to insurers’ administrative and operating costs and profits. Isolation: Independence BCBS recently launched a new initiative aimed at addressing loneliness and...
Sep 8, 2022 | Autism, Behavioral, BRG Publications
BRG recently estimated the Applied Behavioral Analysis (ABA) market size for children ages 6 and under to be nearly $4b in 2022—and growing ~13% annually to more than $6b in 2026. The growth in the market has brought criticisms of some autism providers, such as pushing too many hours on patients and prioritizing profits, while also raising questions about the efficacy of ABA therapy. Click to read more.
Sep 7, 2022 | Uncategorized
The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: CO: Expands private duty nursing benefit IA: Intends to award contracts to Amerigroup and Molina Healthcare WV: Anticipates more than 200k will need to renew eligibility once PHE ends Click to read more.
Sep 6, 2022 | Hospitals, Inpatient, LTCHs, Medicare
CMS Final IPPS and LTCH Rules, Payment Increases for FY 2023: Inpatient hospitals will see a 4.3% increase in operating payments, while long-term care hospitals will get a 2.3% payment increase. Click to read more.
