Sep 2, 2022 | Managed Care Friday
56: Percent of 8,806 college students we polled who said they’ve skipped going to the clinic despite sore throats and congestion for fear of being quarantined and “miss the home opener” or frat-sorority “darty” – a daytime party in the quad, which is a term I did not know about until the kids filled me in. This is “the worst kind of mental health for a college kid” one sophomore said. A far greater portion of freshmen – around 75% - have avoided going to see a doctor or clinic because they live in “on-campus” dorms, so a positive Covid test is like getting grounded by your folks on a spring...
Aug 30, 2022 | Medicare, Payers
In the 2023 PFS Proposed Rule, CMS is considering revisions to the Medicare Shared Savings Program (MSSP) ACOs. MSSP is the largest value-based arrangement in the country. The proposed changes include increasing the amount of time ACOs can remain under one-sided risk arrangements, providing upfront shared savings payments, updating benchmarking methodologies, relaxing caps to HCC risk coding increases, health equity adjustments to ACO quality scores, and policies to reduce administrative burden for ACOs in the program. Click to read more.
Aug 26, 2022 | Managed Care Friday
6.5%: The average increase in US employers spend for employee healthcare coverage in 2023 compared to this year, according to an Aon report, bringing the average cost per employee to around $13,800. The year-over-year rise between 2021 and 2022 was only 3.7%, indicating inflation will likely begin to show up in healthcare costs next year. Because healthcare providers are often in years-long contracts with insurers, the impact is not always felt as immediately as in other industries. Capping PT Pay: A growing number of insurers are capping the amount PTs and OTs can get paid per visit. A...
Aug 23, 2022 | Medicare, Physician Fee Schedule
Surgical Specialties: General, Plastic, Thoracic: Recent developments in general, plastic, and thoracic surgical specialties include mixed Medicare FFS reimbursement trends and stable Medicare spending. Click to read more.
Aug 23, 2022 | Medicare, Physician Fee Schedule
ENT & Audiology: Recent developments in ENT and audiology include mostly positive Medicare FFS reimbursement trends and stable Medicare spending. Click to read more.
Aug 19, 2022 | Managed Care Friday
80: Percent of the total cost that Bluebird Bio will return to insurers if their new FDA-approved gene therapy Zynteglo doesn't stop the need for patients to get regular blood transfusions. The gene therapy costs $2.8 million. Bundle This: We did a poll of 932 parents about what influences their healthcare usage. The amount of time they have to reschedule or miss appointments is going up, and if it were them, they would put pediatrics, dental, orthodontics and physical therapy into one center with a gym. "I'd want the gym for me," quips Molly Rastro, 37, of Connecticut, who says she's...
Aug 16, 2022 | Drugs, Legislation/ Budgets/ Macro, Medicare, Part D
Inflation Reduction Act: Senate reconciliation bill includes energy and ACA subsidies, tax increases, prescription drug price limits in Medicare, and Medicare Part D redesign. CBO's initial projection indicates a net reduction of healthcare spending of $50B over ten years. Click to read more.
