Managed Care Friday

Apr 2, 2021 | Managed Care Friday

5G: Vitas Healthcare, a hospice and palliative care provider, is working with AT&T to test whether virtual reality delivered through a 5G network can help reduce pain and anxiety for patients receiving end-of-life care. Large institutions like USC, Spectrum Health, Emory and the VA have all launched programs utilizing 5G in unique ways to try to better patient care. Value Contracts: 79 health plan payment innovation directors out of 100 we polled last month say they are building out condition-based episodic structures that will be the same across patient populations – commercial,...

Weekly Medicaid Update

Mar 31, 2021 | Medicaid

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: FL:  House budget proposal includes Medicaid cuts for hospitals and nursing homes IN:   Rate updates for certain DME and medical supplies MN: State expands Medicaid substance use disorder services MO: House votes against funding voter-approved Medicaid expansion Click to read more.

Managed Care Friday

Mar 26, 2021 | Managed Care Friday

59: Percent of 35-45 year olds in our consumer poll who said they will “likely” or “definitely” choose Cologuard’s at home test for colon cancer when the time comes over Colonoscopy, several citing advantages like “not having to do the prep my dad did” or not “having to be sedated” and even financial benefits for those who say they may just pay cash “and I think the at home is a lot cheaper”. If a Cologuard test is positive, the patient will need a Colonoscopy, but only 39% knew this. However, the cost of the Colonoscopy in this situation would be applied to the patient’s deductible if they...

Weekly Medicaid Update

Mar 24, 2021 | Medicaid

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: AL:  State considering Medicaid expansion, following incentives in COVID bill CA:  Package of Medicaid-related bills introduced in Legislature GA:  Senate and House pass FY22 budget bills NC:  State extends COVID-related rate increases and policies through June 2021 OH:  State finalizes several changes to dental program Click to read more.

Recent Developments in Anesthesiology

Mar 23, 2021 | Physicians

Recent developments in anesthesiology include negative FFS reimbursement changes, increased focus on surprise billing, and changes to payment design among commercial payers. Click to read more.

Managed Care Friday

Mar 19, 2021 | Managed Care Friday

90%: Amount of hospitals undertaking artificial intelligence initiatives, up from just 53% in 2019, according to a new report published by Sage Growth Partners. While many of these programs are still in the planning or early implementation phase, it’s clear that healthcare executives understand the benefits of this technology and are using AI to make health systems better for both patients and providers, particularly in the wake of the pandemic. Doctor Amazon?: The online retailer runs health clinics near worksites in Dallas-Fort Worth, Phoenix, Louisville and, more recently, Michigan and...

Weekly Medicaid Update

Mar 17, 2021 | Medicaid

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: MN:  State releases RFP for Twin Cities area MCO contracts NJ:   DMHAS releases RFP for emergency department opioid reduction options TX:   Stakeholders oppose proposed rates for new ABA benefit NY:   State Senate passes one-house budget resolution restoring Medicaid cuts Click to read more.

Gaps In Pediatric Dentistry

Mar 16, 2021 | Autism, Behavioral, Commercial Insurance, Dental, Medicaid, Payers

A low supply of pediatric dentists is creating challenges for state policy leaders and dental insurers who are trying to increase early intervention of oral health. In a continued effort to expand data analytics capabilities, BRG recently gained access to Medicaid claim and encounter data for all 50 states and Washington DC, which includes information on dental cleanings and other services. Click to read more.

Managed Care Friday

Mar 12, 2021 | Managed Care Friday

$4,229: The average total savings when using bundled payment programs for surgeries, according to a new study published by Rand on March 1st. The study looked at one payer’s program in which procedures including knee and hip replacements, spinal fusion and bariatric weight loss surgeries used a set bundled payment for all care within a 30-day period. More Than A Feeling: Nonprofit Atrius with more than 30 primary care medical offices and 715 physicians in the Boston area is now an Optum company. High Life: Highmark Health, which increased membership recently through its acquisition of...