Jun 25, 2019 | Commercial Insurance, Exchanges, Payers
Employers will be able to offer employees Health Reimbursement Arrangements to pay for premiums and out-of-pocket costs associated with individual market health plans and Medicare private plans, based on a final rule issued by the Trump Administration. The rule is effective in 2020 and while the impact will depend on employer uptake, given the timing, few employers will elect this option in the first year. Click to read more.
Jun 21, 2019 | Managed Care Friday
1. 18 and Counting The number of ancillary contracting directors for insurers who have confirmed with me that they have had at least one conversation with Amazon in the last 2 years. 2. New #1: Orthopedics has moved past maternity as the #1 episodic payment contracting focus for payers. 3. 7 Wonders of the Lab World: Now that UnitedHealthcare has tapped 7 preferred clinical and anatomic path labs for its preferred network set to go live in July the question is can this mix of big chain and specialized genetic companies improve outcomes and satisfaction. UHC says it will work with the labs to...
Jun 11, 2019 | Legislation/ Budgets/ Macro
CBO releases an annual list of budget deficit reduction options, that includes both spending cuts and tax increases. As the federal fiscal position deteriorates rapidly in the 2020s policies similar to some or all of the CBO options will begin to appear on the policy agenda. The 2019 list includes policies with significant impacts on Medicare Advantage, Medicaid, Medicare beneficiary cost-sharing and hospitals. Click to read more.
Jun 7, 2019 | Managed Care Friday
1. 345: The number of moms and dads we polled about a seemingly mundane question – how they decide where to go for healthcare. Moms seem more thoughtful – relying on their OBGYN or their neighbor who’s a pediatrician, or Dr. Oz and NPR, while Dads, somewhat predictably, rely on ‘it getting better without them doing anything or, increasingly, the nearest urgent care. Moms are more often changing doctors and more thoughtful about where to go and whose advice to use. Unlike Elaine of Seinfeld fame who failed to change doctors because her last one wrote in her medical record that she was too...
Jun 4, 2019 | MedPAC, Physician Fee Schedule, Physicians
In its annual March Report, MedPAC paints a fairly stable picture of physician payments in the post-SGR, early MIPS period, with the gap between Medicare and commercial rates maintaining a similar level over the past few years. MedPAC also reiterated some past positions including a call for increased payments for primary care and a continued criticism of the MIPS physician payment program. Click to read more.
Jun 2, 2019 | Legislation/ Budgets/ Macro
President Trump has issued an executive order directing federal agencies to implement several healthcare policy initiatives. The most significant policy goal is increased healthcare price transparency, but the EO also contained directives related to several other issues including HSAs, surprise billing, and medical research. Click to read more.
May 31, 2019 | Managed Care Friday
67: My high schooler is getting roped into two things – kids asking him to do juul or vape and online gamers called Hofr urging him to predict results from the NBA finals without paying a dime. Jack isn’t biting on the juul offer, thankfully, but he and buddies are all-in on the latest pre-gambling addiction craze Hofr. It seems harmless, but in a straw poll of 74 boys in my son’s high school, 67 of them are betting on these games ‘almost daily.’ This may seem outside of managed care trends but if you look closely it’s another symptom of the iphone generation’s obsession with their apps –...
May 30, 2019 | ESRD, MedPAC
MedPAC recommends that Congress maintain the 2020 ESRD payment update that is specified under current law, which is projected to be +1.9%. Click to read more.
