Telemedicine Today: May 2016

American Well

Telemedicine Today: May 2016. Welcome to the May 2016 edition of Avizia’s Telemedicine Today! 28% Annual Increase in Telemedicine Visits Provided to Medicare Beneficiaries. Harvard Medical School researchers found that the number of telemedicine visits provided to Medicare beneficiaries increased by 28 percent per year from 2004 to 2013 with 107,000 visits provided in 2013. Despite these restrictions, telemedicine use within the Medicare program is growing.

Telemedicine Today: April 2016

American Well

Welcome to the April 2016 edition of Avizia’s Telemedicine Today newsletter! In case you missed them, here are a few updates from Avizia: Avizia is among the 10 Most Promising Telemedicine Solution Providers of 2016. The Center for Medicare and Medicaid Services released a long-awaited update to CMS bylaws to align key rules with those of health insurance coverage programs to modernize how states purchase managed care for beneficiaries and strengthens the patient experience.

Telemedicine Today: March 2016

American Well

A year ago, President Obama signed into law legislation that awards a 5% annual payment bonus to physicians who participate in alternative payment models (APMs), and specifically includes telemedicine, even if those services are not reimbursed under Medicare. Today, 30% of Medicare payments are tied to APMs and are projected to hit 50% in 2018. So far, 2016 seems to be keeping pace. The post Telemedicine Today: March 2016 appeared first on American Well.

Telemedicine Today: February 2016

American Well

February 2016. Large health plans and even the Centers for Medicare & Medicaid Services are starting to reimburse for virtual care, starting first and foremost with the telehealth platforms. According to a 2015 National Business Group on Health survey, 74 percent of large employers expect to offer telehealth services to their employees in 2016. The post Telemedicine Today: February 2016 appeared first on American Well. Telemedicine Today.

Growing Support for Medicare for All – But Do People Really Understand What It Means?

Health Populi

Let’s start with the Morning Consult poll results, which compare support for Medicare for All from January 2019 and August 2019. the party’s loudest supporter of Medicare for All. adults surveyed, 50% believed that Medicare is free.

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.

The U.S. Can’t Afford Not to Have a Cure for Diabetes

Insulin Nation

According to the Centers for Medicaid and Medicare Services, the national health care expenditure, in total, for 2014 was $3 trillion, growing 5.3 A July 2016 Associated Press story projected the 2016 spending at $3.35 sponsor.

Could a President Trump Drive Down Insulin Prices?

Insulin Nation

Trump also advocated earlier this year for empowering Medicare to negotiate with drug companies to lower drug prices.

Why You Still Have to Bolus with the First Artificial Pancreas

Insulin Nation

In the meantime, Dr. Kowalski said, JDRF will be working to ensure that the 670G, and other future artificial pancreas systems, are covered by insurance and Medicare.

Could a President Clinton Drive Down the Price of Insulin?

Insulin Nation

Allowing Medicare officials to negotiate prices with drug companies (Trump has talked up this proposal more than Clinton).

FDA Approves Dexcom G5 as Replacement for Most Fingersticks

Insulin Nation

The news should also provide more fodder for those in the diabetes community who are calling on Medicare regulators to declare CGMs necessary medical devices whose costs should be covered by Medicare plans.

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.

GAO: PBMs passed on nearly all Part D rebates to plans in 2016

FierceHealthIT

A federal watchdog found that pharmacy benefit managers passed on nearly all Medicare Part D rebates on to plan sponsors in 2016, as the amount of rebates skyrocket.

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.

The Top 10 Questions Physicians Ask About Telehealth

American Well

Each major payer type – Medicare, Medicaid and Commercial payers – has different guidelines for reimbursement and telehealth coverage. ( Reprinted from HealthcareIT News ). By Dr. Peter Antall, Chief Medical Officer.

What’s on Dexcom’s Radar?

Insulin Nation

On August 2nd, 2016, Dexcom held a conference call to present its quarterly financial report. If so, this would lead to Medicare-contracted insurance plans covering the cost of CGMs as reimbursable durable medical equipment.

We Have No Idea What Donald Trump is Going to Do About Insulin Prices

Insulin Nation

Drug pricing was not the centerpiece of his populist rhetoric, but on the campaign trail he did briefly describe his plans to have Medicare negotiate for better drug prices; he also signaled his intent to remove hurdles to importing cheaper drugs made abroad. Commentary.

Five Ways a Good Digital Health Registry Addresses Healthcare System Needs

The Digital Health Corner

The Physician Quality Reporting System (PQRS) has been used since 2015 as a metric to determine negative Medicare payment adjustments to providers who do not meet quality standards. digitalhealth analytics clinical trials digital health digital health technology EHR FDA healthcare economics Healthcare IT healthcare reform healthcare vendors informatics mHealth mobile health statistics technology telehealth #hcldr EMR healthcare healthcare IT Medicare pharma

Five Public Health Needs for Digital Health Technology

The Digital Health Corner

digitalhealth digital health digital health technology education FDA fitness healthcare economics healthcare reform medical apps medical devices mHealth mobile health patient advocacy patient engagement pharma remote patient monitoring technology telehealth wireless health hcsm healthcare finance hospitals Medicare S4PM smartphone apps

FDA Panel Recommends Expanded Use of CGMs

Insulin Nation

Industry watchers believe, and many diabetes advocates hope, that today’s vote will add weight to arguments made that CGMs ought to be a covered item of durable medical equipment under Medicare health plans.

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.

Finally, Some Concrete Use Cases for Telehealth

Chilmark Research

The Diabetes Prevention Program (DPP) model , which the Centers for Medicare & Medicaid Services (CMS) wants to take national, emphasizes counseling in the form of weekly in-person group visits, with topics such as barriers to healthy eating and physical activity.

Australians with Type 1 Have an Easier Time with Health Insurance

Insulin Nation

We also have a government-funded Medicare system. I read many stories from the U.S. diabetes community about their ordeals with insurance, and I feel bad for those who have to fight with their insurance companies about these things.

Lilly CEO Defends Profits Made on Insulin

Insulin Nation

Trump has said he would require the Medicare program to negotiate for lower drug prices, while Clinton has proposed several initiatives that she believes will lead to downward pressure on drug prices. CEOs sometimes say things during conference calls that later come back to haunt them.

Enough About the Starbucks Cup Already!

Insulin Nation

Here’s the thing: a barista or a cabbie isn’t in charge of screening my daughter for Type 1, or deciding whether continuous glucose monitors should be covered by Medicare, or choosing to raise the price of insulin yet again.

Bringing Digital Health to Those Who Need It Most

Chilmark Research

It’s for athletes with money to burn, not seniors on Medicare collecting Social Security. In 2016, it’s a great way to drive a tech business into the ground.

Next Generation ACO Model Bodes Well for Telemedicine Reimbursement

American Well

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. By Kofi Jones, VP of Government Affairs, American Well.

Readers Suggest a Diabetes Naughty-or-Nice List

Insulin Nation

until 2016.” Other Medicaid HMOs are bound to deny this benefit in 2016.” “Medicare and the U.S. No Medicare policy of any type will cover the cost of continuous glucose monitors or the sensors needed for CGMs in 2016.”

New Bipartisan Legislation Promotes Telemedicine

American Well

4442 in the House) would greatly expand providers’ ability to leverage innovative telehealth healthcare technologies to increase access to healthcare for Medicare enrollees—and be appropriately paid for doing so. Removing Medicare Barriers to Telemedicine. By Kofi Jones.

#IBMWoW cognitive solutions for cyber threat analysis and collaboration

The Healthcare Guys

I’ll be attending IBM’s World of Watson 2016 in Las Vegas next week. Department of Health and Human Services (HHS) Office of Inspector General’s (OIG) released its 2016 Work Plan.

Can We Shut Up About the Starbucks Cup Already?

Insulin Nation

Here’s the thing: a barista or a cabbie isn’t in charge of screening my daughter for Type 1, or deciding whether continuous glucose monitors should be covered by Medicare, or choosing to raise the price of insulin yet again.

The Top Telehealth Terms to Know

American Well

AW9: American Well’s next generation product line, AW9 , was revealed at HIMSS 2016 in Las Vegas. Mobile SDK: American Well introduced the industry’s first mobile software development kit as part of the AW9 launch in March 2016.

ACOs saved Medicare $2.7B to date, outpacing CMS estimates

FierceHealthIT

Accountable care organizations in the Medicare Shared Savings Programs have saved Medicare $2.7 billion to date, including $859 million in 2016, according to a new analysis commissioned by NAACOS.

Healthcare Pyramid: the Healthcare Navigator needs telehealth

American Well

Re-admissions drive up costs, providers can be penalized, and hospitals can lose Medicare supplements. Sometimes we forget that good healthcare requires not only a diagnosis and a treatment plan but also patient compliance (a willingness to come along on the journey to wellness). But patient compliance often faces obstacles in the form of the fear and anxiety that beset patients and their loved ones, or when a provider faces an unusual condition.

Telemedicine CEO pleads guilty in $424 million Medicare fraud scheme

Henry Kotula

The Justice Department in April brought charges against 24 defendants including Stockett for their role in a $424 million conspiracy to defraud Medicare and receive illegal kickbacks. Medicare paid brace suppliers more than $200 million for these claims, according to the Justice Department.

First Mother’s Day Without Mom

Kaiser Permanente Center for Total Health

Patti Harvey, senior VP, Medicare Clinical Operations and Population Care, and executive director, Care Management Institute, has been a nurse for years, but nothing in her training prepared her for her role as her mother’s caregiver.

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

Medicare Hospice Program Vulnerable According to Inspector General Report

BHM Healthcare Solutions

Editor’s Note: The growth of Medicare Advantage as a program (it accounts for a third of Medicare enrollees and spending), and the 9.3% CMS data showed Medicare spending for hospice care rose 81 percent between 2006 and 2016, from $9.2.

Medicare Reimbursement for Remote Monitoring Should Drive Adoption (What a long, strange trip it’s been….)

The cHealth Blog

The Centers for Medicare & Medicaid Services (CMS) released the 2018 Physician Fee Schedule about two weeks ago and there is at least one nugget in there that should speed the adoption of remote patient monitoring.

KFF: Small share of Medicare Advantage and Part D enrollees switched up plans

FierceHealthIT

Only a small share of Medicare Advantage and Part D beneficiaries switched their health plans during the 2016 and 2017 open enrollment, even though plan options have expanded, a new analysis finds