Insulin Nation

MAY 10, 2016

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. Now, that argument’s premise is facing serious questions in federal court and in the Medicare appeals process.

Medicare 75

Medicare Nursing 75

American Well

JUNE 28, 2015

For its part, the Centers for Medicaid and Medicare Services (CMS) is taking a step forward in supporting the wider use of telemedicine. “It’s been a long time coming, but this ruling making signals a clear and bold step in the right direction for Medicare,” Jonathan Linkous, CEO of ATA, said in a statement.

Telemedicine 48

Telemedicine Telehealth Primary Care Medicare 48

BHM Healthcare Solutions

OCTOBER 2, 2018

Editor’s Note: Medicare Advantage organizations (MAOs) continue to do a poor job of maintaining accurate provider directories—and it’s landing some in hot water with the federal government. The OIG’s report, released in September, found Medicare Advantage organizations overturned about 216,000 denials annually during the period.

Medicare 40

Medicare 40

Insulin Nation

JULY 17, 2015

Senate Committee on Aging convened a special session July 15th to welcome delegates to the 2015 JDRF Children’s Congress and to take testimony in support of a variety of diabetes-related legislation. I was surprised and troubled to learn that CGMs have been denied coverage under the Medicare program,” Senator Collins said at the hearing.

Medicare 76

Medicare 76

Digital Health Wire

NOVEMBER 30, 2023

The glaring white space in that portfolio happens to be one of the biggest growth engines for insurers, the Medicare segment. While Cigna’s been trying to build momentum in Medicare Advantage since picking up HealthSpring in 2011, just this month it announced that it’s “ evaluating options ” to offload its underperforming MA unit.

Medicare 59

Medicare Primary Care Digital Health 59

FierceHealthIT

MAY 7, 2019

Between 2012 and 2015, 1.2 million Medicare beneficiaries were treated by providers who committed fraud or abuse—and many of these patients were from vulnerable populations, according to a new study.

Medicare 97

Medicare 97

BHM Healthcare Solutions

MAY 1, 2018

Payers are rapidly becoming educated in telehealth and are keen on closing telehealth gap, but need to be mindful of Medicare requirements. Almost a third of telemedicine claims sampled by HHS’ Office of Inspector General did not meet Medicare requirements, resulting in an estimated $3.7

Medicare 40

Medicare Telehealth Telemedicine 40

FierceHealthIT

APRIL 19, 2019

Humana has made strides toward its goal of bringing more “healthy days” to its Medicare Advantage members, according to a new report. since 2015. The insurer released a report Monday that shows the communities participating in its "Bold Goal" project have collectively cut down unhealthy days by 2.7%

Medicare 97

Medicare 97

CMS.gov

MARCH 2, 2018

Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Funding Opportunity: Measure Development for the Quality Payment Program. Jeremy.Booth@c…. Fri, 03/02/2018 - 16:30. Kate Goodrich, M.D., Director, CMS Center for Clinical Standards and Quality & CMS Chief Medical Officer. Billing & payments. Initiatives. Leadership.

Medicare 20

Medicare Leadership Mental health Patient Experience 20

FierceHealthIT

SEPTEMBER 13, 2019

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.

Medicare 69

Medicare 69

Telebehavioral Health Institute

SEPTEMBER 24, 2018

Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is new legislation in the United States. In May 2018, the Center for Medicare and Medicaid Services Administration (CMS) released a brief but noteworthy document entitled, Summary of Policies in the … Read more.

Medicare 40

Medicare Telehealth 40

Aging in Place Technology Watch

AUGUST 31, 2022

And that the costs (estimated at $754 million in 2015) were mostly paid by Medicare and Medicaid (the latter likely in nursing homes.) Did you know that the majority of hip fractures are from falling, usually sideways ? Did you know that medical costs from falls was $50 billion in were projected to be $52 billion in 2020?

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Nursing Medicare 131

CMS.gov

JANUARY 6, 2020

In 2015, Congress passed the Medicare Access and CHIP Reauthorization Act – or MACRA. In an attempt to streamline multiple quality programs for physicians, the law created the Merit Based Incentive Payments System (MIPS).

Medicare 62

Medicare 62

Health Populi

JUNE 1, 2021

While Apple product purchases in 2015 were. We can look to Medicare Advantage programs in the current landscape of health care payment: these plans and “payviders” have an incentive to adopt useful tech that helps people care for themselves at home and on-the-go, and there are examples of plans doing just that.

Digital Health 332

Digital Health Medicare Telemedicine Health Technology 332

Healthcare IT Today

JULY 10, 2023

Company Adds Two Board Members and a Senior Executive to Lead its Medicare Advantage Business Aledade , the largest network of independent primary care practices in the country, today announced the closing of a $260 million Series F funding round to enhance and acquire services and technology to support its practices.

Primary Care 52

Primary Care Medicare Health Information Leadership 52

Health Populi

MAY 20, 2021

now, looking at health citizens’ trust in five segments of the health care industry between 2015 and 2021. to approve Medicare’s negotiation of drug prices with pharmaceutical companies]. to approve Medicare’s negotiation of drug prices with pharmaceutical companies]. Let’s focus in on the U.S.

BioTech 310

BioTech Pharmaceuticals Leadership Medicare 310

FierceHealthIT

MARCH 13, 2018

Using government databases, the report found that 54% of doctors who wrote prescriptions to Medicare patients in 2014 and 2015 for opioids received a payment from pharmaceutical companies that make the drugs.

Pharmaceuticals 75

Pharmaceuticals Medicare 75

Healthcare IT Today

MAY 15, 2023

“Apixio has been a trusted business partner since our relationship began in 2015,” said Sarah M. With a patented data science infrastructure, Apixio analyzes structured and unstructured data to develop high-fidelity patient health profiles and support value-based care programs. London , Chief Executive Officer at Centene.

Medicare 81

Medicare Connected Care healthcare technology Healthcare IT 81

Aging in Place Technology Watch

APRIL 2, 2020

Well, as of 2015, only one-third offered free Wi-Fi to residents. But since doctors are now being reimbursed as though the visit was in person, that has been clarified to enable Medicare reimbursement for telehealth during the ’30 day’ plan of care. But nursing homes, specifically?

Remote care 141

Remote care Telehealth mHealth Nursing 141

Healthcare IT Today

JULY 19, 2022

Additionally, with this certification, Canvas customers are now eligible for value-based payment models in Medicare and Medicaid programs, as well as many commercial value-based programs. . Founded in 2015, Canvas is reimagining the EMR for the future of healthcare. About Canvas Medical.

EMR 52

EMR Digital Health Primary Care RCM 52

Connected Health Initiative

FEBRUARY 27, 2023

When Congress enacted the Medicare Access and CHIP Reauthorization Act (MACRA) in 2015, it sought to transition traditional Medicare’s fee-for-service payment system to one that facilitates innovation and care coordination while also improving patients’ health outcomes.

Digital Health 52

Digital Health Connected Health Medicare Telehealth 52

CMS.gov

NOVEMBER 16, 2018

2018 Medicare Fee-For-Service improper payment rate is lowest since 2010. Administrator, Centers for Medicare & Medicaid Services. 2018 Medicare Fee-For-Service improper payment rate is lowest since 2010 Significant progress in saving $4.59B in estimated improper payments for the Medicare Fee-For-Service program.

Medicare 20

Medicare Nursing FHIR Leadership 20

South Central Telehealth Resource Center

OCTOBER 24, 2017

House of Representatives, allows for an expansion of telehealth/telemedicine coverage under the Medicare Advantage Plan B. Medicare Advantage Plan B is an optional insurance that covers medically necessary and preventative healthcare services, supplies, and select prescription medications for individuals 65 and older.

Telehealth 57

Telehealth Medicare Accountable Care Telemedicine 57

BHM Healthcare Solutions

MAY 21, 2019

From 2015 to 2018, federal fee-for-service payments to surveyed AMGA members decreased 20 percent. That’s up from 42 percent of 2015 survey respondents. Medicare Advantage was the most dominant payment model AMGA members relied on in 2018. Commercial fee-for-service payments declined by 8 percent during that period.

Medicare 40

Medicare 40

Healthcare IT News - Telehealth

JULY 1, 2020

The VUC system had been in place since 2015, explained the team in the manuscript, with the goal of providing rapid access to care for low-risk clinical conditions.

Telehealth 207

Telehealth Psychiatry Primary Care Healthcare IT 207

Healthcare IT Today

AUGUST 29, 2022

Programs such as the Medicare Shared Savings Program (MSSP) are mandating high-revenue healthcare organizations, often hospitals and health systems, progress towards downside risk in increasingly shorter timelines. Founded in 2015, CareHarmony is one of the fastest growing solution providers for chronic disease management.

Accountable Care 59

Accountable Care Medicare Health IT Healthcare IT 59

Healthcare IT Today

AUGUST 26, 2022

When VBC programs were expanded as part of the Affordable Care Act in 2010 and the Medicare Access and CHIP Reauthorization Act (MACRA) in 2015, there was hope that the existing fee-for-service model would begin to decline.

Primary Care 87

Primary Care Medicare Healthcare IT Patient Experience 87

New Age Healthcare

JULY 22, 2020

In the United States alone, focused safety improvements led to an estimated US$28 billion in savings in Medicare hospitals between 2010 and 2015. The cost of prevention is much lower than the cost of treatment due to harm. Greater patient involvement is the key to safer care.

Medicare 118

Medicare Patient Experience 118

DrKumo Remote Patient Monitoring

FEBRUARY 14, 2022

In response, the Centers for Medicare and Medicaid Services (CMS) have deployed several codes for remote monitoring service reimbursement. Average National Medicare Payment Amount for 99457, 99458, and 99091. The general national payment amount under the 2022 Medicare Physician Fee Schedule [3] is: 99457: $50.18. 99458: $40.84.

Medicare 52

Medicare 52

BHM Healthcare Solutions

MARCH 19, 2019

Editor’s Note: Increasing costs for prescriptions is creating a long-term financial impact on Medicare Part D and its beneficiaries. Blue Shield of California launched its narcotic safety initiative in 2015, and has since seen average daily dose among chronic opioid users fall 33 percent.

Medicare 40

Medicare 40

care innovations

APRIL 25, 2018

million in telehealth claims per year “did not meet Medicare requirements,” the Office of Inspector General (OIG) at the Department of Health & Human Services (HHS) has thrust new light upon America’s byzantine telemedicine reimbursement policies and the limitations they place on the expansion of value-based care.

Telemedicine 49

Telemedicine Medicare Telehealth Health Policy 49

Telebehavioral Health Institute

DECEMBER 13, 2022

This was endorsed by the World Health Organization (WHO) in 1990 and adopted in the United States on October 1, 2015. Therefore, the telephone E/M CPT codes 99441, 99442, and 99443 will be removed from the Medicare Telehealth Services List and assigned a bundled status. . These distinctions may help: CPT Codes. 45 minutes.”

Telehealth 52

Telehealth Medicare Public Health Mental health 52

Connected Health Initiative

JULY 14, 2021

CHI’s Value-Based Care Task Force (Task Force) report is based on a review of the healthcare ecosystem’s implementation of value-based care models to date, including in the context of Medicare. Congress and the U.S.

Digital Health 52

Digital Health Connected Health Health Technology Medicare 52

Aging in Place Technology Watch

MAY 26, 2022

Good news -- seventy-six percent of the 65+ population as of 2020 has access to broadband -- and tech adoption has clearly risen since 2015. Telehealth vs. in-person: the Covid-19 public health emergency declaration to reimburse doctors for providing telehealth services for Medicare recipients has been repeatedly renewed.

Telehealth 75

Telehealth Nursing Medicare Patient Experience 75

ACA Times

MAY 8, 2016

If you had minimum essential coverage for 2015, simply check the box indicating so on your 2015 tax return. In 2015, if you did not have minimum essential health coverage for the year or for a period(s) throughout the year, you must make an individual shared responsibility payment for yourself and your dependents.

Medicare 40

Medicare 40

Hinduja Global Solutions

JULY 29, 2019

The objective is to develop and validate a predictive model for 15-month mortality using a random sample of community-dwelling Medicare beneficiaries. Data source The Centres for Medicare & Medicaid Services’ Limited Data Set files containing the five per cent samples for 2014 and 2015. million beneficiaries.

Medicare 40

Medicare Patient Experience 40

American Well

JANUARY 15, 2016

This week the Centers for Medicare & Medicaid (CMS) unveiled the Next Generation ACO Model , which allows select Medicare ACOs to assume more risk in service of pursuing efficient and effective patient care. And for a broader understanding of the telemedicine reimbursement landscape, read the reimbursement blog post from 2015.

Telemedicine 48

Telemedicine Medicare Telehealth 48