Aug 12, 2022 | Managed Care Friday
70,000: The number of new healthcare jobs added in July, according to the Labor Department’s monthly job report, bringing the industry within 0.5% of its February 2020 employment level. In a sign of the way healthcare is moving, the majority of those jobs were in ambulatory services, ~47,000 compared to just 13,000 in hospitals. 9,000 new jobs were in nursing and residential care facilities. Drug Cost Sea Change: CivicaScript, part of a nonprofit launched by several health systems and 18 BCBS plans, launched its first drug this month, abiraterone, the generic form of Zytiga. Prostate cancer...
Aug 5, 2022 | Managed Care Friday
$906: The average out-of-pocket cost for people with employer-sponsored insurance in 2019, compared to just $737 in 2013. A new analysis by the Employee Benefit Research Institute shows that the share of medical expenses paid by people enrolled in employer-sponsored coverage increased from 17.4% in 2013 to 19% in 2019. Out-of-pocket expenses dipped in 2020, probably due to the pandemic, but as these costs continue to rise, more and more insured patients are likely struggling to afford healthcare visits and procedures on top of their monthly premiums. This could lead to deferred care,...
Aug 2, 2022 | Post-Acute Care, Skilled Nursing Facilities (SNF)
CMS Finalized FY23 SNF Payment Rates: CMS finalized payment policies changes that would result in an overall $904M increase in payments to SNFs for FY 2023. The increase is driven by market basket updates, offset by the first year of a required budget neutrality adjustment of -4.6% (-2.3% each year of a two-year parity phase-in) to account for overpayments from the transition to the Patient Driven Payment Model. Click to read more.
Aug 2, 2022 | Inpatient Rehab (IRF), Post-Acute Care
CMS Finalized FY23 IRF Policy Updates: The rule finalized a +3.9% update and established a permanent 5% cap for inpatient rehabilitation facilities (IRF) payments related to changes in wage index. Click to read more.
Aug 2, 2022 | Behavioral, Inpatient Psych
CMS Finalized FY23 IPF Policy Updates: The rule finalized a +3.8% updated payment rates and establishes a permanent 5% cap in inpatient psychiatric facilities (IPF) payments related to changes in wage index. Click to read more.
Jul 29, 2022 | Managed Care Friday
1 in 100,000: Prevalence of Addison’s Disease, which Professor Jiwa Moyez says is a good example of the difficulty physicians can have in diagnosing patient symptoms and over-alerting them without appreciating the stress. Particularly for rare conditions that often require multiple tests before a diagnosis can be confirmed, and that are in all likelihood going to rule out the condition eventually. “The patient has to live with the idea that the test is positive” – or going to be, says Moyez, the associate dean of health innovation at The University of Notre Dame, Australia. The diagnostic...
Jul 28, 2022 | ASC, Hospitals, Outpatient
CY 2023 Proposed OPPS And ASC Rule: For 2023, CMS has proposed a +2.7% rate update to the hospital outpatient prospective payment system (HOPPS) and the ambulatory surgical center (ASC) payment system. Click to read more.
