Aug 20, 2019 | ASC, Medicare, Outpatient
CMS has released proposed updates to Medicare payments for services provided in outpatient hospitals and ASCs in 2020. This brief summarizes key highlights of the proposals. Click to read more.
Aug 19, 2019 | Inpatient, LTCHs, Medicare
CMS has released the 2020 final rule for the hospital inpatient (IPPS) and the long-term care hospital (LTCH) payment systems. CMS estimates a 3.0% increase to IPPS payments and a 1.0% increase to LTCH payments in 2020. Additionally, CMS has finalized changes to the hospital wage index to decrease disparities between states. Click to read more.
Aug 16, 2019 | Managed Care Friday
1. 406: The number of responses to our recent caregiver story about the health impact of being a caregiver and what was most shocking was that about half came from those in healthcare, and the other half from educators or business owners, almost all of whom are struggling themselves to take care of their parents. The response is by far the biggest reaction to any one story in the 20 some years of this managed care column. Our full study will be published by 2020 and we will make every effort to incorporate everyone’s ideas. A teacher from Oregon said she wishes her dad trusted others. She...
Aug 14, 2019 | Drugs, Medicaid
Louisiana recently received approval to move forward with their “subscription” model under which Asegua Therapeutics, a subsidiary of Gilead Sciences, will supply, for a negotiated sum, enough hepatitis C drugs to cure virtually all Medicaid patients and incarcerated individuals with hepatitis C over the next 5 years. Click to read more.
Aug 13, 2019 | ESRD, Medicare
CMS proposed a +1.6% update to the ESRD prospective payment system for dialysis facilities in 2020, along with modest policy proposals. The agency also recently introduced a mandatory demonstration program to encourage kidney transplants and use of home dialysis. Click to read more.
Aug 12, 2019 | BRG Publications, Medicaid, Medicaid Managed Care
As the state budget season wraps up, there have been many developments in state Medicaid programs across the country. This report highlights and summarizes key developments related to areas of recent investment activity. Click to read more.
Aug 9, 2019 | Managed Care Friday
1. 72: The percent of caregivers reporting mental stress and physical health declines. In our initial study on caregiver health we found that 91% of those caring for a senior family member with a condition like dementia, Alzheimer’s or cancer report mental stress, 75% report depression, 27% say they have gained weight, 19% say they have lost it, and 25% say they have been to the hospital or urgent care at least once for their own health event. 72% say their overall physical and mental health has declined since becoming more responsible for their mom or dad or relative, partly impacted by...
Aug 7, 2019 | Medicare, Physician Fee Schedule
CMS has released proposed updates to the Medicare Physician Fee Schedule (PFS) for 2020. This brief summarizes key items in the proposed rule. Click to read more.
Aug 6, 2019 | Post-Acute Care, Skilled Nursing Facilities (SNF)
CMS released the final SNF payment and policy updates for FY2020, which closely mirrors the proposal. Full implementation of the payment reform – known as the Patient Driven Payment Model, or PDPM – begins October 1 with a rate increase of 2.4%, slightly below the April estimate. Click to read more.
Aug 6, 2019 | Hospice, Medicare
CMS released the final hospice payment and policy updates for FY2020, which closely mirrors the proposal. The final hospice rule applies a 2.6% market basket update and proceeds with rebasing per diem payments to align with costs, resulting in large increases to the 3 more intensive levels of care, and a slight reduction to routine home care to offset the increases. Click to read more.
