May 5, 2020 | Home Care, Home Health, Hospitals, Inpatient, Inpatient Psych, Inpatient Rehab (IRF), Medicaid, Medicare, Outpatient, Physical Therapy, Post-Acute Care
On April 30, CMS issued its second round of regulatory waivers and changes to increase access to testing and provide greater flexibilities to support care delivery in the wake of COVID-19, including for telehealth services, hospitals, ACOs, home health, and therapists. Click to read more.
May 1, 2020 | Managed Care Friday
Overachiever: So, what happens when the healthcare system starts having unparalleled success in value-based arrangements? What, for example, do insurers think will happen to the target baseline on which a physician is measured, and will insurers share more savings or less? Thoughts here from our poll. Revenue Short: There’s been a little reported issue between reimbursement for Medicare Advantage patients vs. fee-for-service Medicare. While traditional Medicare has allowed providers the discretion to waive cost share during this pandemic, that will come out of the provider’s books as...
Apr 28, 2020 | Legislation/ Budgets/ Macro
The fourth phase of COVID-19 legislation added $75B to the HHS provider relief fund, for a total of $175B. Starting April 10, providers are eligible for funding, based on Medicare FFS revenue. Click to read more.
Apr 27, 2020 | Inpatient Rehab (IRF)
The FY 2021 Inpatient Rehabilitation Facility (IRF) proposed rule, released on April 16th, estimated a +2.9% increase in net payments. The proposed rule included several measures aimed at expanding scope of practice for non-physician practitioners, and proposed permanently removing post-admission evaluation requirements to alleviate administrative burden. Click to read more.
Apr 24, 2020 | Managed Care Friday
21: Percent spike in the number of prescriptions filled per week for antidepressant, anti-anxiety, and anti-insomnia medications between February 16 and March 15, according to an Express Scripts report. Sales peaked the week ending March 15, when COVID-19 was declared a pandemic. Anti-anxiety medication use rose the most, at +34.1%. Glidepath to Risk: Just because there’s a pandemic doesn’t mean risk contracting has stopped, interestingly, as we’re hearing more payers and providers continuing to explore risk contracts. And why not? With the downtick in visit volume, it’s not a bad time to be...
Apr 22, 2020 | Legislation/ Budgets/ Macro
The 4th COVID-19 bill focuses on small business loans and grants, as well as the next tranche of disbursement from the original $100 billion for healthcare providers. Click to read more.
Apr 21, 2020 | Legislation/ Budgets/ Macro
On April 19, CMS issued guidance for regions with a lower COVID-19 impact: “Non-COVID-19 care should be offered to patients as clinically appropriate and within a state, locality, or facility that has the resources to provide such care and the ability to quickly respond to a surge in COVID-19 cases, if necessary. Decisions should be consistent with public health information and in collaboration with state public health authorities.” Click to read more.
