Mar 22, 2019 | Managed Care Friday
1. 64: Percent of high school seniors in our poll earlier this month who say they are interested in medical school or healthcare jobs, but when ‘breaking out the results’ by gender, the numbers change a lot—girls (73%) and boys (49%). 2. Stroke of Genius: A new remote monitoring program has reduced bad ‘LDL’ cholesterol by 40% in less than 12 weeks, and cut blood pressure values in half according to results we found from Always Health Partners, formally known as Neighborhood Health Plan of Massachusetts. The plan’s remote medical management program is focused on reducing the risk of heart...
Mar 20, 2019 | Commercial Insurance, Payers
Last week, we released a brief that discussed increasing utilization for telehealth services, as well as recent legislation expanding telehealth coverage by public payers. In today’s brief, BRG Director Joanna Younts discusses how changes to commercial payer coverage and reimbursement can fuel growth in the telemedicine industry. Click to read more.
Mar 19, 2019 | Behavioral, Drugs, Products, Substance Abuse
The healthcare sector is mobilizing to combat opioid addiction. BRG expert Bryan Cote discusses how healthcare executives and investors will be instrumental in the coming years, including what existing efforts are worth watching and what risks lie ahead. Click to read more.
Mar 11, 2019 | Physician Fee Schedule, Physicians
BRG analysis finds commercial telehealth utilization continued to grow in 2017, across service types, but most significantly in physician services. This analysis affirms trends BRG previously observed, from 2014 to 2016, using Truven commercial claims data. In this brief, we discuss findings and recent legislation expanding telehealth coverage by public payers. Click to read more.
Mar 6, 2019 | Air, Ambulance
Surprise billing has become an area of increased concern within the healthcare sector, and the air ambulance industry has often found itself at the center of this issue. This brief includes updated data on Medicare utilization, commercial claims data, and state efforts to pass legislation. Click to read more.
Feb 28, 2019 | Legislation/ Budgets/ Macro, Medicare
CMS actuaries project national healthcare spending will grow at an average annual rate of 5.5% through 2027, driven largely by an aging population. Spending growth in Medicare is projected to be the highest at 7.4% per year, with spending by private insurance expected at just 4.8% per year. This continues a trend toward government payers and away from private health insurance, as well as toward faster spending growth than in the previous decade. Click to read more.
Feb 27, 2019 | Ambulance, Ground
CMS recently announced a demo to test new payment models for emergency ambulance care and transport services. Under the Emergency, Triage, Treat and Transport (ET3) Model, CMS will pay participating providers treating Medicare FFS beneficiaries to treat them on scene or transport them to a location other than a hospital, such as an urgent care center, if appropriate. Click to read more.
Feb 22, 2019 | Managed Care Friday
Extra Point: Unlike my kids whose idea of a crisis is their iphone app froze or the dog licked the waffle, meaning they have to make another one, there are real crisis situations going on and they are sparking a flurry of new healthcare psych-focused models. The latest is a new mental health facility focused on helping Medicaid patients in Tennessee, and it’s already at capacity. The center focuses on both crisis intervention and other psych needs, but its model has led to some questions from those we interviewed about its designation, whether it turns away crisis patients, and more broadly...
Feb 21, 2019 | Medicare, Post-Acute Care
In this report, BRG expert Greg Russo, and attorney Katie Pawlitz, address the role of data analytics in fraud investigations in the healthcare industry, both proactively by providers and during the course of a government investigation. The role of sampling in False Claims Act investigations and litigation is also explored in-depth, including a review of case law regarding the legality of sampling for use in addressing liability and damages. Click here to access the paper in BRG Review, Winter 2018 (volume 7).
