BRG Medicaid Update

Jun 17, 2020 | Medicaid

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: –   FL: Reinstatement of prior authorization requirements for Medicaid services –   IL: Closure of NextLevel Health, one of the state’s six Medicaid managed care plans –   PA: CARES Act funding for IDD and autism service providers Click to read more.

Managed Care Friday

Jun 12, 2020 | Managed Care Friday

Interest in women’s health services is rising, but if you are a hospital, doctor group, or healthcare investor – or even if you are a parent or working woman - what are the trends, best opportunities, and potential risks? In this special edition of Managed Care Friday, we offer a snapshot of recent trends and emerging considerations, including results from a hospital CEO poll and survey of over 1,500 adult women. Click to read more.

BRG Medicaid Update

Jun 10, 2020 | Medicaid

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: –   National: CMS announces relief funding for Medicaid providers –   NJ: Proposal to increase reimbursement for LTR substance abuse services, bonus payments –   TN: Addition of methadone clinic services under medically necessary adult benefits –   WA: State agencies directed to identify options for reducing their FY 2021 budgets by 15% Click to read more.

Health System Response to COVID-19

Jun 8, 2020 | Hospitals, Inpatient

In early March, at the outset of the COVID-19 pandemic, BRG’s Market Research team started tracking what payers, hospitals, physician groups, and consumers were thinking, and specifically how they saw themselves changing after the pandemic resolves. About 2,130 individuals with a stake in healthcare shared their views each month, and as March turned to April, and April to May, the more change seemed inevitable as a result of the crisis. In this Eye on Healthcare, we preview what 110 hospital and health system leaders have been experiencing and how they’ve responded. Their views may be a...

Managed Care Friday

Jun 5, 2020 | Managed Care Friday

62: Percent of medical directors, out of 100, we polled who say they get pitched ‘all the time’ on value-based models or capitated payment concepts but often get rebuffed internally from the informatics or actuary team who ‘can’t figure out a way to code’ for the new model and handle all the claims. If there’s a lesson here, it’s that the medical director is important to get on board. You’ll need an ROI argument and a ‘time to ROI’, but ‘you’ll need to be prepared for pushback on how this can work administratively’. Concierge Surgery Benefit: Employer Direct Healthcare of Texas, a healthcare...

BRG Medicaid Update

Jun 3, 2020 | Medicaid

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: –   CA: 10% temporary increase in LTC per-diem rates –   FL: Additional temporary flexibilities for well-child visits using telemedicine –   IL: 20% temporary increase in max. allowable rates for behavioral health and SUD providers –   NC: Transition of CGM products from DME program to Outpatient Pharmacy Point of Sale program Click to read more.

MedPAC March/April 2020 Reports: MSSP, MA, ESRD, and OPPS

Jun 2, 2020 | ESRD, Hospitals, Medicare, Medicare Advantage, MedPAC, Outpatient

In its March and April 2020 public meetings, the Medicare Payment Advisory Commission (MedPAC) provided continuing coverage on the Medicare Shared Savings Program (MSSP), Medicare Advantage (MA), and analyzed select topics involving the ESRD and OPPS payment systems. Separately, MedPAC also released its March 2020 Report to Congress containing analyses of payment adequacy in FFS Medicare and the status of MA and Part D. Click to read more.