Medicare spent $1.4B on discarded Part B drugs in 2017 and 2018: report
FierceHealthIT
AUGUST 20, 2020
Medicare spent $1.4B on discarded Part B drugs in 2017 and 2018: report. Thu, 08/20/2020 - 15:02.
Sepsis hospitalizations cost Medicare $41.8B in 2018 — and that number's likely to grow
FierceHealthIT
FEBRUARY 14, 2020
A new HHS study found that sepsis hospitalizations cost Medicare $41.8B in 2018 alone. Here's why the experts think that figure's likely to keep growing.
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What If Costco Designed the Prescription Drugs Sales Model?
Health Populi
JUNE 5, 2022
In 2006 the Medicare Part D program was implemented, covering older Americans for prescription drugs for the first time. Medicare further drove expansion of generic drug utilization, with co-pays for generics lower for Medicare enrollees than branded drugs. While these four actions to lower drug costs garner over 80% of U.S.
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Medicare Advantage Growth Aggravate Prior Authorization Burdens
BHM Healthcare Solutions
MAY 24, 2023
Medicare Advantage growth aggravates prior authorization burdens in the several ways. Most medical groups, providing care to patients with Medicare Advantage plans, must comply with more prior authorization requirements. References: Centers for Medicare & Medicaid Services. American Medical Association. Prior Authorization.
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KFF: Part D spending on Ozempic skyrocketed between 2018 and 2022
FierceHealthIT
APRIL 1, 2024
Spending on GLP-1 drugs in Medicare Part D has spiked massively over the past several years, according to a new analysis from KFF.
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eHealth's online Medicare enrollment up 69% in Q4 2018
FierceHealthIT
APRIL 2, 2019
An increasing share of eHealth’s Medicare Advantage and Medicare Supplement customers are now enrolling for coverage online.
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Nearly half of physicians using telehealth, up from just 18% in 2018
Healthcare IT News - Telehealth
APRIL 23, 2020
Physicians are changing the patterns of their practice because of the COVID-19 pandemic, with nearly half of them using telehealth to treat patients, up from just 18% in 2018. The 2018 survey had indicated that telemedicine use among physicians was more prominent among younger doctors. WHY IT MATTERS.
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CMS has finalized its remedy for 340B payments, and hospitals are not happy
FierceHealthIT
NOVEMBER 2, 2023
The Centers for Medicare & Medicaid Services has dropped the final rule to remedy the invalidated 340B-acquired drug payment policy for calendar years 2018 to 2022. |
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118 CMS: ACOs saved $739M in 2018 as new program takes hold
FierceHealthIT
SEPTEMBER 30, 2019
million in net savings in 2018, with physician-led ACOs being the biggest savers, according to the Centers for Medicare & Medicaid Services. Accountable care organizations generated $739.4
Insurance Carriers Embrace Telehealth Part I — Medicare Advantage
Ortholive
FEBRUARY 18, 2020
20 million Americans enrolled in Medicare beneficiaries are about to embrace telehealth. The Bipartisan Budget Act of 2018 takes effect this year, and with it, Medicare Advantage customers will have access to telemedicine services to improve their lives.
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4 in 10 Medicare beneficiaries expected to be on Medicare Advantage plans by 2028
FierceHealthIT
NOVEMBER 19, 2018
Medicare Advantage enrollment is expected to increase from 34% of the Medicare population in 2018 to 42% in 2028. Yet CBO forecasts that spending on those enrollees will grow from $200 billion to $580 billion over the same time period.
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CMS finalizes risk adjustment rule for benefit year 2018
FierceHealthIT
DECEMBER 7, 2018
Like many aspects of healthcare this year, the fate of risk adjustment has been hard to predict, but stability is nigh: The Centers for Medicare & Medicaid Services (CMS) finalized the rule for the 2018 benefit year on Friday.
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The Political Plausibility of Medicare for All
Electronic Health Reporter
NOVEMBER 28, 2018
As widely reported, based on exit polls, healthcare—not the economy—was the top issue on voters’ minds in the 2018 midterm elections. The article The Political Plausibility of Medicare for All appeared first on electronichealthreporter.com.
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MedPAC: Hospitals got $201B in Medicare payments last year, a 3.6% bump from 2017
FierceHealthIT
DECEMBER 5, 2019
Hospitals got $201 billion in Medicare fee-for-service payments in 2018, a 3.6% increase from 2017 as Medicare is footing the bill for higher drug prices, a new analysis found.
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86 Mastering Remote Patient Monitoring Reimbursement: A Guide to Medicare Billing Success
DrKumo Remote Patient Monitoring
FEBRUARY 13, 2024
Disclaimer: This blog article, “Mastering Remote Patient Monitoring Reimbursement: A Guide to Medicare Billing Success,” offers general information and is not a substitute for professional advice. Medicare, as a crucial player in healthcare reimbursement, plays a pivotal role in facilitating the adoption of RPM.
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40 Telehealth Policy 2018: Keeping You In The Know
South Central Telehealth Resource Center
MARCH 6, 2018
In 2018, updates and changes impacted telehealth policy across the nation. Medicare and Remote Patient Monitoring (RPM) Reimbursement. Effective January 1, 2018, Medicare began reimbursing providers for RPM services billed under CPT code 99091. Click here to read specific information on the Medicare website.
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MIPS: Find out if you are in or out for 2018
FierceHealthIT
APRIL 8, 2018
The Centers for Medicare & Medicaid Services has released an online tool that enables clinicians to determine whether they must participate in the Merit-Based Incentive Payment Program (MIPS) this year.
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The Centers for Medicare and Medicaid Approved Separate Reimbursements for Non-Traditional Patient Visits
eVisit
NOVEMBER 19, 2018
November 1, 2018 the Centers for Medicare and Medicaid (CMS) made a significant step in overcoming this obstacle. It announced its finalization of “ Revisions to Payment Policies under the Medicare Physician Fee Schedule, Quality Payment Program and Other Revisions to Part B for CY 2019 ”.
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Anthem CEO optimistic about Medicare Advantage going into second half of 2018
FierceHealthIT
JULY 25, 2018
Despite a decline in membership overall, the insurer is confident that it will increase enrollment in its Medicare Advantage plans, including retirees from the commercial market.
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Four Technology Health and Aging Blog Posts from September 2018
Aging in Place Technology Watch
OCTOBER 4, 2018
Here are four blog posts from September 2018: Investors continue to salivate over health tech. So the first half of 2018 saw $3.4 And even when investments or company roll-ups are specifically about the Medicare population – frothy writers cannot bring themselves to use clear wording. Gee, what do they do?
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Trust in Healthcare is Under Stress in the US and Globally, Edelman Finds
Health Populi
MAY 20, 2021
Year-on-year, different spikes and ups-and-downs call out for special mention, such as: Pharma’s 13-point steep dive to 38% between 2017 and 2018, dramatically recovering by 9 points in the last year to 47% [with the wild card here of whether U.S. to approve Medicare’s negotiation of drug prices with pharmaceutical companies].
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What $285,000 Can Buy You in America: Medical Costs for Retirees in 2019
Health Populi
APRIL 8, 2019
That retirement cost gap is the sticker-shock assumption that Medicare is going to cover all health care expenses in retirement. The $285K also assumes the couple doesn’t have employer-sponsored retiree health care coverage and qualifies for “Original Medicare” (not Medicare Advantage, for example).
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Medicare Next Generation ACO Model Telehealth Expansion Waiver
Telebehavioral Health Institute
DECEMBER 21, 2018
As previously discussed, in the United States traditional fee-for-service system of Medicare, use of the telehealth benefit is limited to rural Health Professional Shortage Areas (HPSA). As of January 2018, this restriction has changed for more than 50 “Accountable Care … Read more.
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2018 Medicare Fee-For-Service improper payment rate is lowest since 2010
CMS.gov
NOVEMBER 16, 2018
2018 Medicare Fee-For-Service improper payment rate is lowest since 2010. Fri, 11/16/2018 - 18:46. Administrator, Centers for Medicare & Medicaid Services. Most notably: The 2018 Medicare-FFS improper payment rate decreased from 9.51 percent in 2018. percent in 2018. percent in 2018.
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From Evolution to Innovation, from Health Care to Health: How Health Plans With Collaborators Are Re-Defining the Industry
Health Populi
FEBRUARY 4, 2024
Retail health-meets-Medicare. This work started in 2023 involving Walmart Health clinics serving Medicare members and looking to partner with UnitedHealth plan members and others. Patients and health plan members continue evolving into medical bill payers, with their homes and budgets baked into the concept.
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Nearly Half of Adults Unfamiliar with ‘Medicare for All’
BHM Healthcare Solutions
JANUARY 29, 2019
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. 13-16, 2018, surveyed 1,021 interviewees on their perception of Medicare for All proposals.
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40 Venture Capitalists have poured more than $26 Billion into Health Startups in 2018
Lloyd Price
NOVEMBER 5, 2018
With two months left in 2018, healthcare startups have already raised more in VC funding this year than they did in all of 2012 and 2013 combined, according to an analysis conducted for Forbes by Pitchbook. Reminder: In September 2018 each startup raised $20.7 In 2012 and 2013 combined, the sector raised $22.3 billion in 12 months.
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Health Insurance Plan Ratings for 2018: NCQA Releases Top 10 List
BHM Healthcare Solutions
SEPTEMBER 25, 2018
National Committee for Quality Assurance (NCQA) is releasing its 2018 Health Insurance Plan Ratings. The ratings are a system similar to CMS Star Ratings of Medicare Advantage plans and give unprecedented importance to health outcomes and consumer satisfaction. Top Ten States with the Highest-Rated Health Plans (receiving a 4.5
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Being Transparent About Healthcare Transparency – My Post on the Medecision Blog
Health Populi
DECEMBER 4, 2019
With new rules emanating from the White House this month focusing on health care price transparency, health care costs are in the spotlight at the Centers for Medicare and Medicaid Services. Read my post on getting transparent about transparency in Medecision’s blog here for more details and a deeper dive into this important issue.
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Telehealth is Health: It’s Telehealth Awareness Week
Health Populi
SEPTEMBER 20, 2021
physicians worked in a practice that used telehealth versus 25% who did so in 2018, based on a new survey from the AMA. Hy-Vee also introduced a Medicare Aisle into its grocery stores in August 2021. In 2020, 79% of U.S. And the grocer is expanding its pharmacy footprint , having piloted tele-pharmacy back in 2017.
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Altarum: Growth in spending on privately insured patients outpacing Medicaid, Medicare
FierceHealthIT
JULY 19, 2018
A new analysis from the Altarum Institute found that spending and price growth among the privately insured sped up in 2017 and the first half of 2018 compared to public payers. It's a reversal from prior trends when private spending growth was near or below Medicare and Medicaid rates.
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Cigna and Humana Eye Blockbuster Merger
Digital Health Wire
NOVEMBER 30, 2023
The acquisition of Express Scripts in 2018 also made Cigna one of the biggest names in pharmacy benefits, and its Evernorth health services arm has been adding more fuel to the fire. The glaring white space in that portfolio happens to be one of the biggest growth engines for insurers, the Medicare segment.
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2018 Brings New Changes To ACA Exchange
ACA Times
MAY 8, 2017
The Centers for Medicare & Medicaid Services (CMS) released a final rule relating to the stabilization of the ACA Exchange for 2018. For one, the open enrollment period will be shortened—ending on December 15, 2017 as opposed to January 31, 2018, unless approved for special enrollment.
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40 Worrying About Paying for Health Care Is the Norm in America
Health Populi
SEPTEMBER 24, 2019
This mis-alignment relates to three areas of personal health economics: finance related to Health Savings Accounts (HSAs), Medicare, and long-term care (LTC). For Medicare, two-thirds of future retirees wish they understood the health plan better. employees who participated in 401(k) plans in February 2019.
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The New Drug Companies Aren’t Drug Companies At All
Health Populi
JULY 11, 2019
This research organization will develop medicines targeting older adults — which makes sense because Clover Health’s target consumer market is Medicare Advantage beneficiaries.
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220 Do Medicare providers located at a Distant Site have to be hospital-based to provide services?
South Central Telehealth Resource Center
MAY 24, 2018
Also, all telehealth services must meet the Medicare established set of criteria for reimbursement. Medicare defines a distant site as, “the site where the physician or practitioner, providing the professional service, is located at the time the service is provided via a telecommunications system.”. Do you need technical assistance?
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The Future of Remote Patient Monitoring Telehealth in Post-COVID Healthcare
AMC Health
OCTOBER 12, 2022
Researchers found that Medicare billing for RPM increased by 555% from Jan. 1, 2018, to Sept. Here’s Why Virtual Care is Here to Stay. Throughout the COVID-19 pandemic, Remote Patient Monitoring (RPM) and Telehealth have been steadily increasing.
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64 HEART Act Targets Medicare Limits on Telehealth
American Well
JUNE 25, 2017
the Helping Expand Access to Rural Telehealth (HEART) Act targets the Center for Medicare & Medicaid Services’ (CMS) strict limitations on RPM reimbursements in rural areas. Of the 107,000 telemedicine visits for Medicare beneficiaries recorded in 2013, approximately 40,000 of them served rural areas. Sean Duffy (R-Wis.)
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HEART Act Targets Medicare Limits on Telehealth
American Well
JUNE 25, 2017
the Helping Expand Access to Rural Telehealth (HEART) Act targets the Center for Medicare & Medicaid Services’ (CMS) strict limitations on RPM reimbursements in rural areas. Of the 107,000 telemedicine visits for Medicare beneficiaries recorded in 2013, approximately 40,000 of them served rural areas. Sean Duffy (R-Wis.)
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2019 Medicare Physician Fee Schedule Could Expand RPM Reimbursement
care innovations
SEPTEMBER 5, 2018
Just as it did for the 2018 calendar year , the Centers for Medicare & Medicaid Services (CMS) is seeking to further expand reimbursement for remote patient monitoring, virtual visits and other telehealth services as part of its proposed 2019 Medicare physician fee schedule.
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Study finds 2/3 of healthcare providers aren’t familiar with changes to telehealth reimbursement
Clocktree
JANUARY 10, 2019
On November 1, 2018, the Centers for Medicare & Medicaid Services (CMS) issued an update to payment policies and payment rates for services provided under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2019. The specific changes can be found here: [link].
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Credentialing and Provider Enrollment: Improved Solutions Are Desired for 2018
HealthStream
DECEMBER 19, 2019
Leaders are looking to optimize software solutions which provide methods to improve efficient communication and required payer ongoing verifications, as well as integration with the Council for Accountable Quality Healthcare (CAQH), State Medicaid, and Medicare enrollment.
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2018 Year in Review: The Year’s Biggest Remote Care News & Developments
care innovations
JANUARY 2, 2019
2018 was a historic year for telehealth and remote patient monitoring (RPM), as a series of developments played out that helped extend these important care delivery services to more patients than ever before. January 18, 2018. June 21, 2018. January: Unbundled CMS Code Increases Remote Care Reimbursement. Read more here.
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40 South Central Legislative/Regulatory Update – February 2018
South Central Telehealth Resource Center
FEBRUARY 2, 2018
Reimbursement will be based on the applicable Medicare guidelines and coding for the different service providers. The post South Central Legislative/Regulatory Update – February 2018 appeared first on LearnTelehealth. 016.06.17. 9/20/17: Rule adoptionEffective: 9/30/17. Amends rules regarding advanced practice registered nurse.
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