Oct 25, 2019 | Managed Care Friday
68: Percent of older adults who say the quality of care would not be as good as a face-to-face visit, according to a University of Michigan National Poll on Health Aging, with half saying they did not feel personally connected to the health care professional and 4 in 10 reporting difficultly seeing or hearing. The poll asked a national sample of 2,200 adults, ages 50 to 80, about their ‘tele’ experience. Prostate Story Twist: Nebraska Internist Marvin Bittner ended up buying one of those imaging vouchers through MDSave to cover an MRI his doctor thought was necessary to identify suspicious...
Oct 24, 2019 | Legislation/ Budgets/ Macro, Medicare, Medicare Advantage
President Trump has issued an Executive Order (EO) on the Medicare program. EOs do not directly establish federal regulations, but establish policy directives for the executive branch agencies. The EO covers a wide range of issues including Medicare Advantage, primary care, FDA and CMS approval and coverage processes, data transparency, FFS Medicare rates, and facilitating HSA utilization. Click to read more.
Oct 22, 2019 | Medicare, Medicare Advantage
Medicare Advantage plans project enrollment to grow another 9% in 2020, reaching 24.4 million enrollees, based on bids submitted to CMS. This would put MA on track to reach 40% of total Medicare beneficiaries in 2020, as the program is buoyed by widespread popularity. Click to read more.
Oct 9, 2019 | Medicare, Part D
A recent OIG report found that rebates for brand-name drugs under Part D were effective in slowing spending growth. However, the majority of these savings were accounted for by a small percentage of sampled drugs. Click to read more
Oct 8, 2019 | ESRD, Medicare, MedPAC
CMS released 2 new mandatory Medicare payment models: the Radiation Oncology (RO) Model and the End-Stage Renal Disease Treatment Choices (ETC) Model. MedPAC evaluated both plans and released mixed comments on the ETC Model, and overall positive comments on the RO Model. Click to read more.
Oct 7, 2019 | DMEPOS, Medicare
At its September meeting, MedPAC again pointed to large savings generated by the Medicare DME competitive bidding program (CBP) and brainstormed about how competitive bidding could be expanded to more DME and even beyond. Click to read more.
Oct 4, 2019 | Managed Care Friday
1. 90: Percent of US population who live within 10 miles of a Walmart where finding home goods and supplies probably just got easier now that the retailer has partnered with home health company Amedisys. How the partnership will play out remains to be seen. The objective of ‘Walmart Health’ is to provide clinic-based primary care, counseling, home care, and dentistry, at reduced costs. If our straw poll is any indication, the medical director community isn’t buying yet – just 11% said they anticipate high-quality care at Walmart, with several ‘wondering if the partnership’ could...
Oct 3, 2019 | Legislation/ Budgets/ Macro
A government shutdown has been averted until at least November 21 due to the enactment of a Continuing Resolution over this past weekend. A package of healthcare extenders was also addressed, including a provision related to Medicaid DSH for hospitals and funding for Community Health Centers. Click to read more.
