CMS Proposes FY22 IPPS and LTCH Rules

CMS has proposed the FY22 rules for the hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospitals (LTCHs). This brief summarizes the proposed changes made to the IPPS, which applies to approximately 3,200 acute care hospitals, and LTCHs, which applies to approximately 360 LTCHs. Click to read more.

Managed Care Friday

60: Humana is purchasing the remaining 60% interest of Kindred at Home and will rebrand the company through Humana’s new healthcare services brand, CenterWell, going by CenterWell Home Health. Fully integrating home health allows Humana to accelerate their value-based operating model at scale, more closely focusing on improving patient outcomes and reducing the total cost of care. The payer plans to divest their majority stake in Kindred’s hospice and community care operations. Home Care Oversight: BCBS Michigan is contracting with CareCentrix to manage home health care services for MA...

Weekly Medicaid Update

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: MI:   Rate increases for pediatric psychiatric services NY:  Legislation requires nursing homes to provide daily average of 3.5 hours of care PA:  State to reinstate pre-COVID prior authorization requirements TX:  State revenue outlook significantly improves Click to read more.

BRG Quarterly Health Policy Summaries

This brief summarizes recent activity at MedPAC and MACPAC including: MedPAC: Released Medicare payment system update recommendations, reported ongoing updates to individual policy topics, and updated findings on 4 mandated reports and 1 congressional request of interest. MACPAC: Released Commission’s report to Congress and findings for the mandated report on non-emergency medical transportation (NEMT) and their evaluation of CMS Innovation Accelerator Program (IAP); provided recommendations for Behavioral Health Services; proposed state strategies for DSNP and increases to rebates for high...

Managed Care Friday

24/7: Dartmouth-Hitchcock, along with MDLive, announced a virtual urgent-care service earlier this month. The 24/7 virtual urgent care will connect patients anywhere to clinicians at Dartmouth-Hitchcock, while MDLive physicians will provide back-up coverage. Dementia Risk Rising: Researchers say it’s probable that COVID-19 can increase the risk of getting dementia based on several new studies. You can read the full story here. Multiple Sclerosis Pilot: Highmark has partnered with AllianceRx Walgreens Prime to launch a Social Determinants of Health (SDoH) pilot outreach program targeted at...

BRG Expert Discussion: Healthcare Payer Index 2021

BRG's Managed Care team will host a special forum on the 16th annual Healthcare Payer Index. Managing Director, Bryan Cote, will discuss how the rankings came to be, what payers are thinking, how to get attention, and what to expect for 2022. BRG’s annual Healthcare Payer Index reveals the top 20 health insurer priorities for managing care and costs and how payers are transforming how they pay for healthcare and what they value. The Top 20 payer priorities look a lot different than a year ago: ·       3 services make their debut ·       5 services crack the top 10 ·       7 services fall out...

Weekly Medicaid Update

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: FL:   Legislature proposes FY21-22 budget MA:  House FY2022 budget proposal increases spending OH:  State proposes new Medicaid provider credentialing rule TN:  Medicaid recipients file lawsuit against block grant waiver implementation Click to read more.

BRG Expert Discussion: Healthcare Payer Index 2021

Conference Call | Thursday, April 29th, 1:00 PM ET BRG’s annual Healthcare Payer Index reveals the top 20 health insurer priorities for managing care and costs and how payers are transforming how they pay for healthcare and what they value. The Top 20 payer priorities look a lot different than a year ago: 3 services make their debut 5 services crack the top 10 7 services fall out of the top 20 There’s a new #1 Many of the usual targets are now opportunities On Thursday, April 29th, BRG's Managed Care team will host a special forum on the 16th annual Healthcare Payer Index. Managing Director,...

Recent Developments in Oral Surgery

Recent developments in oral surgery include increases in Medicare FFS spending, decreases in reimbursement for maxillofacial codes resulting from E&M reform, and more use of pre-pay review among commercial payers. Click to read more.

Managed Care Friday

263,999: Square feet, the size of the new ambulatory surgical center Kaiser is building in northern Virginia that will host multiple specialties, including radiology and infusion treatments. The building will boast a farmers' market and a health park with workout stations. Other services planned include nuclear medicine, diagnostic imaging, clinical lab, oncology pharmacies, primary and specialty clinics and a community center. Kaiser is also trying to double its retail clinic network by 2022, according to the company, and is adding 4 clinics in Southern California Target stores. Up In The...