Jan 7, 2022 | Managed Care Friday
131: Number of hours PA Lauren Valley worked at a busy urgent care clinic this past week in my town, often spending off time sleeping at the clinic, filling in for staff who were quarantined. Lauren is a terrific PA – smart, thoughtful, doesn’t just prescribe antibiotics and tests needlessly, calls the sinus issues the little kids have “boogies” but can adapt to help the older lady find her busstop after her appointment. There are thousands of Lauren Valley’s out there – but right about now, we need thousands more… DropOut: Cigna dropped Livongo from preferred status in its digital formulary...
Jan 5, 2022 | BRG Publications, Medicaid
BRG’s 2021 Medicaid Policy Review focuses on key drivers and areas of emphasis for states as we emerge from the pandemic-focused years of 2020 and 2021. The outlook reviews macro trends in enrollment and funding, provider rates, and state policies for people with mental illness and those with intellectual or developmental disabilities. Click to read more.
Dec 21, 2021 | Physician Fee Schedule, Physicians
Cardiology: Medicare FFS payments for cardiology, cardiac surgery, and pulmonary disease have fluctuated +/- 1 to 4% and spending has been largely flat in recent years. Medicare clinical labor reductions and changes to RVUs impact some codes. Click to read more.
Dec 21, 2021 | Physician Fee Schedule, Physicians
Optometry/Ophthalmology: Medicare FFS reimbursement for optometry and ophthalmology mixed in recent years. Program integrity activity for these specialties has become more common and is most often focused on Wet AMD drugs. Click to read more.
Dec 17, 2021 | Managed Care Friday
50%: Increase in families requesting grief support services in 2021 according to Boston Medical Center. Primary care doctors in Boston identify families who could benefit from the Good Grief Program and refer children to the medical center. The program estimates that about 10% of the new families are grieving a loss from COVID-19. Maureen Patterson-Fede, the clinical social worker who oversees the program, expresses worry about the future for these children, “I think we're all holding our breath. We're feeling like we're just seeing the tip of the iceberg about what's going to play out for...
Dec 16, 2021 | BRG Publications
BRG’s fourth annual Healthcare Investment Index includes the Top 10 biggest anticipated priorities for 2022, a review of this year’s deal inquiries, and changes to diligence priorities. “Money is now made during the ownership period more than ever - not on the buy and many see the safety of investing in the industry for the long haul, but some don’t know the risks they are taking - it’s as white hot as I’ve seen it in my twenty-five-plus years," according to a senior private equity executive on the changing landscape of healthcare investment. The report includes a new playbook for investment...
Dec 13, 2021 | Legislation/ Budgets/ Macro, Physician Fee Schedule
Just a week ahead of the Treasury’s deadline for a debt ceiling increase, a bipartisan agreement was reached allowing Democrats to unilaterally raise the limit on the nation’s debt—while also delaying several Medicare payment cuts to providers. Click to read more.
Dec 10, 2021 | Managed Care Friday
2.3: Percent of 8-year-olds in 11 states diagnosed with autism in 2018, up from 1.9% in 2016, according to new data released by the CDC, which shows that childhood autism rates are at their highest level yet. Utilizing a new ASD surveillance method that relies on ASD diagnosis, special education classification and medical billing codes, researchers were able to capture more fully all those diagnosed. A separate report shows that 4-year-old children born in 2014 were 50% more likely to be diagnosed with autism or given an ASD special education classification compared to 2010. Luckily, most...
