Telemedicine - 2010 & 2011 - Part 1 Public Policy

LinkousThink

Speeches in 2010 by the head of Medicare in the U.S. 2011 will be the critical year when we find out whether leaders in Washington and other world capitols will follow-through with specific actions. We will wait and see in 2011 what effect how the governments’ plans will actually have on accelerating broadband deployment. Here is the first of three pieces on where we have been in 2010 and where we are going next year for telemedicine.

Moving Our Eggs Out Of One Basket

LinkousThink

Medicare Advantage is offered mostly as a private managed care insurance plan and covers about 25 percent of all Medicare patients. billion to buy HealthSpring, which has 340,000 customers in its Medicare Advantage program in 11 states. According to Gary Capistrant, ATA’s resident expert on all things related to health policy, at least 73 million Americans, almost one quarter of the population, are now covered under some form of managed care.

I will no longer say “turning the corner” when it comes to telemedicine

LinkousThink

physicians and reported a first quarter profit for 2011 of $3.7 For years we talked about reaching the point when telemedicine services became self-sustaining outside of temporary grants, going from promise to reality. We have long passed the point of telemedicine being a new application. After eighteen years the corner is turned and I promise to put that phrase away.

Six Misperceptions

LinkousThink

Despite what you hear, Medicare reimbursement is not the Holy Grail for telemedicine. It’s important, but… Medicare fee-for-service covers about 36 million Americans, 12 percent of the total U.S. Healthcare is a $2 trillion market in the United States and growing at a fast pace. For entrepreneurs, that figure is so alluring it is impossible to ignore. Companies, institutions and individuals from everywhere are looking to see how to get a piece of the healthcare market.

On Snooze Alarms

LinkousThink

Donald Berwick, Administrator of the Centers for Medicare and Medicaid Management said “There has never been a better time to be an innovator in health care.” A clever and well worn trick to resist change and protect the status quo by funding and regulating organizations is the use of demonstration or pilot projects.

Medicare Drug Prices Up Despite Decrease in Prescriptions

BHM Healthcare Solutions

Editor’s Note: Increasing costs for prescriptions is creating a long-term financial impact on Medicare Part D and its beneficiaries. Total Medicare reimbursement for all brand-name drugs ballooned 77 percent from 2011 to 2015.

Medicare Told to Cover CGMs in Ruling

Insulin Nation

Medicare doesn’t typically provide coverage for continuous glucose monitors (CGMs), as insurors who oversee Medicare coverage have long argued that CGMs are a “precautionary” device rather than a “medically necessary” one. The Medicare-insuring contractor denied the claim.

OIG: Part D rebates grew but not enough to offset price spikes

FierceHealthIT

Rebates for Medicare Part D grew by $2 billion from 2011 to 2015, but the growth was limited to a minority of Part D drugs, a federal watchdog found

ACO Lessons Learned: Revisiting the Timing of Downside Risk

E-CareManagement

Here’s the article in a nutshell: One of the most critical aspects of the Medicare Shared Savings Program (MSSP) ACO has been around the timing and certainty of requiring mandatory downside financial risk for physician and hospital participants.

Hearing aid pricing and weak insurance – older adults lose out

Aging in Place Technology Watch

The majority of responders were women, though in the general population hearing loss affects twice as many men as women – one study in 2011 attempted to figure out why men are less regular users – concluding that poor handling of the devices was a factor. What is really worrisome is that hearing aids, which correct a condition that can cause substantial health issues, including fall risks and dementia, which are costs to Medicare, are considered an ‘elective’ device.

Study: Hospital Prices Show ‘mind-boggling’ Variation

BHM Healthcare Solutions

In 2011, the study shows that hospital prices for lower-limb MRIs are 12 times higher in the most expensive region of the US (Bronx, New York) than in the cheapest region (Baltimore, Maryland) and can vary by up to a factor of 9 within the same city (i.e.

Health Costs for People with Diabetes is 3.6 Times More than Average

Insulin Nation

An older study by the Centers for Disease Control and Prevention (CDC) found that out-of-pocket expenses actually decreased for people with diabetes on Medicare and Medicaid over a 10-year-period.

Why the RPM Codes for 2019 are Different, and – Most Importantly – SPOT ON!

care innovations

Ultimately, when new procedures or services are made available for reimbursement from the Center for Medicare and Medicaid Services (CMS), those procedures are assigned a Current Procedural Terminology (CPT) code, which is used when submitting the claim for payment.

National Clinical Care Commission: “Laser-like” Review of Diabetes Programs, Policies

Insulin Nation

As far back as 2011, Congressman Pete Olson (R-TX) and Senators Jeanne Shaheen (D-NH) and Susan Collins (R-ME) have championed legislation to create an office within the federal public health apparatus to focus exclusively on fostering diabetes research and improving access to quality care.

The Two Canoes: Fee-for-Service Reimbursement for Remote Patient Monitoring

care innovations

Thank you to the Alliance for Connected Care, The Center for Connected Health Policy, Krista Drobac, Nathaniel Lacktman, David Ryan, the Center for Medicare and Medicaid Service and many others for your persistence in driving change and moving American healthcare forward.

CMS’s PI interoperability rule change is a good start, but is there more it can address?

Healthcare Guys

To end the lack of interoperability morass and data duplication, the Department of Health and Human Services (HHS) issued 1,883 pages of proposed changes to Medicare and Medicaid. The healthcare industry has attempted to bridge the gap between medical data and quality patient care.

EHR 52

New Diabetes Bill Signed into Law by President Trump

Insulin Nation

The commission will include the heads of agencies whose mission is impacted by diabetes care; this includes the usual suspects like the CDC and the Centers for Medicare and Medicaid Services, but also agencies like the Department of Defense and the Department of Agriculture.

Recognition, Reimbursement, Results: Why 2017 Was a Win for Connected Health

ConnectedHealth

We worked with the Centers for Medicare and Medicaid Services (CMS) to propose incentive and reimbursement opportunities for the use of remote monitoring tools, we urged the U.S. What’s more, many Medicare doctors and hospitals rely on improvement activities to meet their MIPS requirements. 2) CMS Activated the Reimbursement Codes for Remote Monitoring Tools, Too 2017 also saw the “unbundling” of Medicare reimbursement code 99091.

Trump’s Health Picks Provide Clues to Affordable Care Act Fate

Insulin Nation

In addition, it was announced that Mr. Trump has chosen Seema Verma, a private health policy consultant who worked closely with the state of Indiana, to be the head administrator of the Centers for Medicare and Medicaid Services. Verma, who would head the Medicare and Medicaid programs.

How Hospitals Are Reducing Medical Costs with Telehealth

American Well

The federal government has pegged the cost of hospital readmissions for Medicare patients at $26 billion annually, with $17 billion accounting for readmissions that result in patients not receiving the right care. In 2011, hospitals spent $41.3 In 2011, hospitals spent $41.3

Will CMS’s PI rule review be a sweet change or is it just pie in the sky?

Healthcare Guys

To end the lack of interoperability morass and data duplication, the Department of Health and Human Services (HHS) issued 1,883 pages of proposed changes to Medicare and Medicaid. For the first time a new CMS rule specifically requires providers to share data to participate in the life blood of hospital reimbursement—Medicare and Medicaid. Will CMS’s PI rule review be a sweet change or is it just pie in the sky?

CMS’s Proposed PI Rule Changes: A Good Start, but is it Enough?

Healthcare Guys

To end interoperability morass and data duplication, the Department of Health and Human Services (HHS) issued 1,883 pages of proposed changes to Medicare and Medicaid. For the first time, a new CMS rule specifically requires providers to share data to participate in the life blood of hospital reimbursement — Medicare and Medicaid. AWVs were first introduced by private insurers and then by CMS in 2011 as part of its preventative care initiative under the Affordable Care Act (ACA).

CMS’s Proposed PI Rule Changes Is A Good Start But Does It Address Enough

Healthcare Guys

To end the lack of interoperability morass and data duplication, the Department of Health and Human Services (HHS) issued 1,883 pages of proposed changes to Medicare and Medicaid. For the first time a new CMS rule specifically requires providers to share data to participate in the life blood of hospital reimbursement—Medicare and Medicaid. By Thanh Tran, CEO, Zoeticx and Donald Voltz, MD, Aultman Hospital, Department of Anesthesiology, Medical Director of the Main Operating Room.

CMS’s Proposed Interoperability PI Rule Changes Is A Good Start, But Does It Address Enough?

Healthcare Guys

To end the lack of interoperability morass and data duplication, the Department of Health and Human Services (HHS) issued 1,883 pages of proposed changes to Medicare and Medicaid. For the first time a new CMS rule specifically requires providers to share data to participate in the life blood of hospital reimbursement—Medicare and Medicaid. By Thanh Tran, CEO, Zoeticx & Donald Voltz, MD, Aultman Hospital, Department of Anesthesiology, Medical Director of the Main Operating Room.

EHR 40

Are PBMs Driving Up The Price of Insulin?

Insulin Nation

The Medicare program relies on private insurance carriers, under long-term national and regional contracts, to pay out benefits and make available purchase of prescription drugs at discount for Part C and often deeper discount for Part D beneficiaries.

CMSs Proposed PI Rule Changes Is A Good Start, But Does It Address Enough?

Healthcare Guys

To end the lack of interoperability morass and data duplication, the Department of Health and Human Services (HHS) issued 1,883 pages of proposed changes to Medicare and Medicaid. The rule also floats the idea of revising Medicare and Medicaid Co-Pays to require hospitals to share patient records electronically with other hospitals, community providers and patientsa clear-cut demand for interoperability.

The Burgeoning Role Of Venture Capital In Health Care

Henry Kotula

It is considered the nation’s largest federally recognized provider of the Centers for Medicare and Medicaid Services (CMS) Diabetes Prevention Program, having received more than $125 million in venture funding since it was founded in 2011. .

HIPAA 41

Weekender 6/7/19

HIStalk Weekender

A healthcare cyberattack report by cloud endpoint protection vendor Carbon Black notes that hackers are going after administrative records of physicians that can be used to fraudulently bill Medicare and other insurers. million for the property, which the county values at $14 million, in 2011.

HIStalk Interviews Jason Krantz, CEO, Definitive Healthcare

HIStalk Interviews

Definitive Healthcare was started in 2011. We also have information around the quality of care provided and the Medicare penalties or incentives that each of these facilities is achieving. Jason Krantz, MBA is founder and CEO of Definitive Healthcare of Framingham, MA. Tell me about yourself and the company. Our goal is to be the premier provider and the single source of truth for all data on healthcare providers. In the last seven or eight years, we’ve grown significantly.

Ensuring Safety and Quality in America’s Nursing Homes

CMS.gov

Administrator, Centers for Medicare & Medicaid Services. The SSAs visit and survey every Medicare and Medicaid participating nursing home in the nation at least annually to ensure they are meeting CMS’ health and safety requirements as well as state licensure requirements. Ensuring Safety and Quality in America’s Nursing Homes. Jeremy.Booth@c…. Mon, 04/15/2019 - 19:22. Seema Verma. Topic. Nursing facilities. Quality. Safety.

Review of Mobile Devices and Health by Ida Sim in the NEJM

mHealth Insight

57 A recent change in the Medicare Physician Fee Schedule that allows physician billing for time spent managing and interpreting data from remote monitoring (e.g., If you need a really obvious example think about the benefits of SMS appointment reminders (from 2011).

Weekender 5/18/18

HIStalk Weekender

My first inclination is to at least publish the Medicare price. The photo above is of his patients’ medical records that were stored in “an unsecured and dilapidated barn” where he tried to hide them from Medicare. Weekly News Recap.

EMR 36

The Tech Giants are Coming for Healthcare

Lloyd Price

Medicare/Medicaid Management One other play that is harder to decipher starts with Amazon’s announcement in March to cut its prime membership for Medicaid recipients by over 50% and CNBC’s announcement that it’s been talking potential collaborations with AARP since 2015.

Healthcare has never experienced anything like Amazon’s combination of logistics, voice AI expertise and data analytics. The impact could be huge.

Lloyd Price

And as part of its efforts to target the aging infirm, the company began offering Prime discounts to Medicare recipients. Google Health was shuttered in 2011 after only about three years of operation, and Microsoft nixed its own personal health tracking system, HealthVault, earlier this year.

Telemedicine, Telehealth, Remote Monitoring and the Latest Congressional Health Reform Proposal

LinkousThink

The bill calls on the federal Center for Medicare and Medicaid Services (CMS) and other parts of the Department of Health and Human Services (HHS) to compile data and launch pilot programs designed to reduce hospital readmissions. Language beginning on page 97 of the document addresses recommendations made by the Medicare Payment Advisory Committee (MedPAC) about readmissions. This week, the United States Senate Finance Committee announced its proposed health reform bill.