Feb 22, 2022 | Physical Therapy, Physician Fee Schedule
PT/OT, Chiropractic, and Physiatry: Recent developments in PT/OT, chiropractic, and physiatry include mixed Medicare reimbursement and increasing coverage from commercial payers. Click to read more.
Feb 18, 2022 | Managed Care Friday
45: Percent of people who say technical issues interfered with their ability to effectively utilize telehealth services, according to a recent study conducted by the Bipartisan Policy Center and Social Science Research Solutions. For many of us, it’s because we can’t remember our passwords, but for rural and older populations, there are more barriers, including lack of broadband internet access. Roughly 4 in 10 report these obstacles compared to 2 in 10 among younger people and those who live in cities. Some Medicaid and MA plans have started covering broadband as a benefit, like Humana’s...
Feb 15, 2022 | 340B, Drugs, Pharmacy
Over the last several years, covered entities in the 340B drug discount program have contended with Medicare cuts to reimbursement and manufacturer restrictions on selling discounted drugs to contract pharmacies. As litigation proceeds on both fronts with a SCOTUS ruling on reimbursement due in summer 2022, 340B stakeholders continue to face uncertainty surrounding vital aspects of the program. Click to read more.
Feb 11, 2022 | BRG Publications
Top 20: Health plan priorities usually change about as often as my kids do the dishes, which is to say rarely, and when they do it’s usually with a bit of nudging, like the regulator who mandates payers cover mental health. But there is a theme percolating inside commercial and government payers that is going to force change among those of us delivering care, according to the '22 payer index. There’s a renewed commitment to collecting data on the cost and quality of doctors, facilities, therapists, and diagnostics, then using it to steer people to the best. Of course, it’s not clear to me...
Feb 8, 2022 | Legislation/ Budgets/ Macro, Medicare, Uncategorized
CMS released the 2023 Medicare Advantage Advance (MA) Notice on February 2, 2022. The proposed rate updates in combination with CMS’ estimate of payment increases due to risk coding behavior would increase MA plan payments by +7.98% relative to last year. Click to read more.
Feb 4, 2022 | Managed Care Friday
40%: Proportion of MVP Health Care’s Medicaid members who have not seen a primary care provider in the last 18 months. To change this, MVP, a health plan with members in New York and Vermont, recently launched a bilingual app for its Medicaid members that will connect them with primary and specialty care. The health plan partnered with Galileo, a tech-driven medical group, to create the virtual offering as a way to help members access services despite impediments many of them face, including transportation and language barriers. Dog On It Ortho: Orthopedic specialists and some health...
Jan 28, 2022 | Managed Care Friday
62: The percentage of consumers who are not familiar with value-based care, according to a recent study conducted by EmblemHealth. The health plan surveyed 970 consumers online in 2021 and found that more than half were not familiar with the concept at all, and only 25% of those familiar with VBC could correctly define the model. My own bride, who occasionally has to listen to me carry on about all things value, thought it had something to do with vouchers for supplies for people who stop smoking or lower cholesterol. If the healthcare system wants to truly move toward value-based payment...
