#WWBR Week of July 27, 2015

Chilmark Research

“Alzheimer’s is poised to seriously strain the Medicare (and Medicaid) budgets especially starting in the later 2020s as more and more Boomers enter into their 70s and 80s since the risk of Alzheimer’s notably begins to increase after age 70.

HIPAA 78

Telemedicine Today (#tday): December 2015

American Well

Welcome to the the final edition of Avizia’s Telemedicine Today for 2015! As another year approaches its end, we take a look back at 2015 as a year of great progress in the evolving Telemedicine industry. A few of Avizia’s proudest moments from 2015: Forbes – Avizia Is Transforming Healthcare Through Telemedicine. A bipartisan group of senators are “very close” to finishing a bill aimed at increasing Medicare payment for telemedicine services. “We’re

Senate Hears Testimony for Medicare CGM Coverage

Insulin Nation

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. Two months later, a Medicare appeals council reversed the judge. The U.S.

3 Big Healthcare Trends To Watch in 2015

BHM Healthcare Solutions

October 1, 2015 is the much-anticipated roll out date of ICD-10 , the 10 th revision of the World Health Organization’s system to classifying “ medical records, including diseases, symptoms, abnormal findings and external causes of injury.”

HIPAA 67

Telemedicine Today (#tday): September 2015

American Well

Medicare Telehealth-Based Chronic Care Management. Telehealth and the Medicare Access and CHIP Reauthorization Act. The post Telemedicine Today (#tday): September 2015 appeared first on American Well. Welcome to the September edition of Avizia’s Telemedicine Today! For those new to this feature, we share the telehealth industry’s hottest news, events, legislation, insight and more. Fall has officially arrived in Virginia!

Telemedicine Today (#tday): July 2015

American Well

Last week, Representatives Devin Nunes and Frank Pallone reintroduced a bill that will allow licensed providers to treat Medicare beneficiaries using telemedicine across state lines. Known as the Telemedicine for Medicare, or TELE-MED, Act of 2015, seeks to address state licensure laws that create barriers for providers to practice telemedicine in states where they are not licensed. The bill only applies to Medicare beneficieries and has no impact on Medicaid.

Telemedicine Today (#tday): June 2015

American Well

For its part, the Centers for Medicaid and Medicare Services (CMS) is taking a step forward in supporting the wider use of telemedicine. When final payment rules governing how Medicare will pay healthcare providers and suppliers in 2015 were released last October, CMS added seven procedures to the telehealth list of covered services, including annual wellness visits, psychotherapy services, and prolonged services in the office.

Why Every Child Should Be Tested for Type 1

Insulin Nation

North Carolina legislators introduced identical bills in the state’s House (HB 20, January 28, 2015) and Senate (SB 27, February 3, 2015) to require medical practitioners who provide well-child care to ensure that diabetes screening is performed upon each child at birth, and then at ages one and two.

Telemedicine Reimbursement

American Well

Lack of understanding about how each of the three major payer types—Medicare, Medicaid, and commercial payers—reimburse for telemedicine visits has understandably prevented many providers and delivery systems from making informed decisions about adopting this technology. Medicare .

15 Ways to Save Money on Diabetes Care

Insulin Nation

Medicare is a government-sponsored program for people over age 65 as well as younger people with serious health problems, including kidney failure. Medicare now covers most diabetes supplies & prescriptions as well as dietary & educational counseling.

15 Ways to Save Money on Diabetes Care

Insulin Nation

Medicare is a government-sponsored program for people over age 65 as well as younger people with serious health problems, including kidney failure. Medicare now covers most diabetes supplies & prescriptions as well as dietary & educational counseling.

Speaking Up to Make Pumps Safer

Insulin Nation

He’s helped lead a lobbying effort to persuade Congress to require Medicare to pay for the services of certified diabetes educators and to cover the expense of continuous glucose monitors.

Congress talking health IT cash — Teladoc offers a trend to watch — Medicare struggles to incorporate gene tests for drug metabolism

Morning eHealth

Congress talking health IT cash

How Hospitals Are Reducing Medical Costs with Telehealth

American Well

implementing the technology in 2015. 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.

MACRA: New Reimbursement Legislation in the US

Telebehavioral Health Institute

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. The post MACRA: New Reimbursement Legislation in the US appeared first on TBH Institute Blog.

The NCQA Welcomes 2 Important Vendors to the eMeasure Certification Program

BHM Healthcare Solutions

The eMeasure Certification Program launched in July of 2015 is designed to “certify the data extraction and reporting process” the new systems that are used to process all kinds of healthcare data. NCQA Press Release November 24th, 2015: [link].

American Well CEO Talks the Future of Telehealth

American Well

How are telehealth product offerings going to evolve in 2015 and beyond? The second is the coverage of telehealth under Medicare. We believe both will take place in 2015. Telehealth is dynamically changing the way both patients and physicians view healthcare. Nobody knows this better than Roy Schoenberg, co-founder and CEO at American Well. Roy introduced the patented service brokerage technology used by his company, which is currently the nation’s largest telehealth network.

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 Advantage Organizations Overturned 75% of Their Denials

BHM Healthcare Solutions

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. Financial Medicare and Medicaid Medicaid Medicare payment models Value Based Payments

Rebalancing Tech In Favor of Talk

American Well

Alan Pitt ‘s latest blog reminds us that the last great transition in American medicine occurred in 1965 when President Johnson signed Medicare Medicaid legislation into law, establishing a safety net for many previously uninsured Americans.

Washington Managed Fee-for-Service Demonstration: 2015 and 2016 Medicare Actuarial Savings Report

CMS.gov

Washington Managed Fee-for-Service Demonstration: 2015 and 2016 Medicare Actuarial Savings Report. Director, Medicare-Medicaid Coordination Office, Topic. Medicare Parts A & B. Washington Managed Fee-for-Service Demonstration: 2015 and 2016 Medicare Actuarial Savings Report. Today, the Centers for Medicare & Medicaid Services (CMS) released a report that demonstrates how empowering states can help reduce costs.

Medicare improperly paid $34M to medical equipment suppliers: OIG

FierceHealthIT

Medicare is only supposed to pay inpatient facilities for durable medical equipment used during patient stays. Yet OIG found $34 million that Medicare channeled directly to suppliers of such equipment between 2015 and 2017

Reimbursements red herring, trust, and key infrastructure needs for Telemedicine success

The Healthcare Guys

Medicare for instance covers face-to-face interactions, but only when the originating site (point of care, not the patient’s home) is in a Health Professional Shortage Area (HPSA). Telemedicine is a growing part of modern healthcare, and could play a pivotal role in the U.S.’s s efforts to streamline and expand preventative services. Virtual, video-based doctor’s appointments can help alleviate the general practitioner shortage, and encourage preventative care.

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.

Telehealth Payments Don’t Meet Medicare Requirements

BHM Healthcare Solutions

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 Access and CHIP Reauthorization Act of 2015 (MACRA) Funding Opportunity: Measure Development for the Quality Payment Program

CMS.gov

Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Funding Opportunity: Measure Development for the Quality Payment Program. The Meaningful Measure Areas serve as the connectors between CMS goals under development and individual measures/initiatives that demonstrate how high quality outcomes for our Medicare, Medicaid, and CHIP beneficiaries are being achieved.

BCBS Reduces Opioid Use Among Members by 56 Percent

BHM Healthcare Solutions

Editor’s Note: Increasing costs for prescriptions is creating a long-term financial impact on Medicare Part D and its beneficiaries. Increasing costs for prescriptions is creating a long-term financial impact on Medicare Part D and its beneficiaries.

MACRA: Medicare’s Opportunity to Finally Embrace Connected Health Technology

ConnectedHealth

The nation’s healthcare system is in the middle of a major transition – one that, if done well, will have an incredible impact on the lives of millions Americans who rely on Medicare. For a long time, Medicare has had a reputation for being bureaucratic, lethargic, wasteful, and outdated. Further, the Center for Medicare and Medicaid Services (CMS), which administers Medicare, has been slow to incorporate advances in advanced health technology in the program.

Why Drug Prices Keep Going UP

BHM Healthcare Solutions

Editor’s Note: Increasing costs for prescriptions is creating a long-term financial impact on Medicare Part D and its beneficiaries. Between 2013 and 2015, prices rose by nearly 10 percent, six times the rate of general inflation.

Drug Prices Soar After Shortages

BHM Healthcare Solutions

Editor’s Note: Increasing costs for prescriptions is creating a long-term financial impact on Medicare Part D and its beneficiaries. Increasing costs for prescriptions is creating a long-term financial impact on Medicare Part D and its beneficiaries.

Study: Patients treated by fraudulent providers often most vulnerable

FierceHealthIT

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.

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

Fred Trotter on Data Journalism and Cybersecurity — Harlow on Healthcare

Health Blawg

He’s the co-author of O’Reilly’s first health IT book, Hacking Healthcare, and the 2015 recipient of the Healthcare Data Liberator of the Year award. Fred notes that the DocGraph dataset of Medicare physician relationships with patients is the largest graph dataset — i.e. a dataset organized with nodes and edges — using real-name data out there, and is one of the few “people” graphs that are open.

Fred Trotter on Data Journalism and Cybersecurity — Harlow on Healthcare

Health Blawg

He’s the co-author of O’Reilly’s first health IT book, Hacking Healthcare, and the 2015 recipient of the Healthcare Data Liberator of the Year award.

Fred Trotter on Data Journalism and Cybersecurity — Harlow on Healthcare

Health Blawg

He’s the co-author of O’Reilly’s first health IT book, Hacking Healthcare, and the 2015 recipient of the Healthcare Data Liberator of the Year award.

The The Five Biggest Areas of Opportunity for Digital Health

The Digital Health Corner

According to most recent statistics from the Office of the National Coordinator, use of EHRs has increased from 20% in 2004 to 87% in 2015. digitalhealth clinical trials digital health digital health technology EHR healthcare economics Healthcare IT healthcare reform informatics mHealth mobile health patient engagement remote patient monitoring smartphone apps technology telehealth ACOs government IT healthcare healthcare IT HHS hospitals Medicare medicine S4PM

Fred Trotter on Data Journalism and Cybersecurity — Harlow on Healthcare

Health Blawg

He’s the co-author of O’Reilly’s first health IT book, Hacking Healthcare, and the 2015 recipient of the Healthcare Data Liberator of the Year award. Fred notes that the DocGraph dataset of Medicare physician relationships with patients is the largest graph dataset — i.e. a dataset organized with nodes and edges — using real-name data out there, and is one of the few “people” graphs that are open.

Fred Trotter on Data Journalism and Cybersecurity — Harlow on Healthcare

Health Blawg

He’s the co-author of O’Reilly’s first health IT book, Hacking Healthcare, and the 2015 recipient of the Healthcare Data Liberator of the Year award. Fred notes that the DocGraph dataset of Medicare physician relationships with patients is the largest graph dataset — i.e. a dataset organized with nodes and edges — using real-name data out there, and is one of the few “people” graphs that are open.

Fred Trotter on Data Journalism and Cybersecurity — Harlow on Healthcare

Health Blawg

He’s the co-author of O’Reilly’s first health IT book, Hacking Healthcare, and the 2015 recipient of the Healthcare Data Liberator of the Year award. Fred notes that the DocGraph dataset of Medicare physician relationships with patients is the largest graph dataset — i.e. a dataset organized with nodes and edges — using real-name data out there, and is one of the few “people” graphs that are open.

Humana making strides toward its 'Bold Goal'—but work remains on behavioral health

FierceHealthIT

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%