Industry Voices—'Medicare for All' might work. Here's what definitely does

FierceHealthIT

Unlike Medicare for All, employer on-site clinics need neither presidential support nor a law passed by Congress

HIStalk Interviews Jason Krantz, CEO, Definitive Healthcare

HIStalk Interviews

Jason Krantz, MBA is founder and CEO of Definitive Healthcare of Framingham, MA. Definitive Healthcare was started in 2011. Why did HIMSS sell its HIMSS Analytics business and how did Definitive Healthcare end up acquiring it? The match with Definitive is about being a good shepherd of that data. We also have information around the quality of care provided and the Medicare penalties or incentives that each of these facilities is achieving.

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Medicare: Cover CGMs Now!

Insulin Nation

Unfortunately, Medicare policy hasn’t kept up with evolving diabetes technology, and policymakers have left out CGMs from the list of reimbursable diabetes devices. There have been several petitions circulating to pressure lawmakers to make Medicare cover CGMs.

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.

Do Medicare providers located at a Distant Site have to be hospital-based to provide services?

South Central Telehealth Resource Center

Q: Per Medicare regulations, do the providers at a distant site have to be hospital-based or can they be in a private setting – for example, a group of pulmonologists who want to create a telehealth system on their own? Also, all telehealth services must meet the Medicare established set of criteria for reimbursement. Click here to visit the Medicare Eligibility Analyzer site. To review CCHP information on Medicare, go to: [link]. Medicare

The Promise of Telehealth for Older People – the U-M National Poll on Healthy Aging

Health Populi

Health Populi’s Hot Points: I recently collaborated with HealthMine on a survey looking into Medicare Advantage members’ views of health and digital technology.

CMS’ Rural Health Strategy Could Expand Medicare Telehealth Reimbursement

care innovations

Congress and the Centers for Medicare & Medicaid Services (CMS) have generated hope among health plans, insurers, providers and patients that Medicare telehealth reimbursement is set to expand significantly in the year ahead. A series of moves in recent months by the U.S.

HEART Act Targets Medicare Limits on Telehealth

American Well

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. Currently, CMS has a narrow definition of “rural,” which leaves many patients ineligible for reimbursement. Of the 107,000 telemedicine visits for Medicare beneficiaries recorded in 2013, approximately 40,000 of them served rural areas. are on Medicaid and/or Medicare.

Changes to Medicare Advantage Plans Could Allow for Expansion of RPM Services in Senior Care

care innovations

And that means that “senior living companies that double as Medicare Advantage insurers” will be given the opportunity for reimbursement for new modes of care targeting patient with chronic conditions. Changes to Medicare Advantage Plans Designed to Reduce Rehospitalizations.

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.

Blockchain in Healthcare: A Vehicle Towards Digital Health 2.0?

The Digital Health Corner

A good definition of blockchain is: “A blockchain , [1] [2] [3] originally block chain , [4] [5] is a continuously growing list of records , called blocks, which are linked and secured using cryptography. [1] I would like to apologize to the readers of this site for the long hiatus. I have been spending time as cardiologist, consultant, and caregiver for a seriously ill family member. My goal is to continue writing as it is something I truly love to do.

Why People Are Still Avoiding the Doctor (It’s Not the Virus)

Henry Kotula

I definitely am avoiding appointments.”. A pharmacist helped, but Mr. Chapman no longer has insurance, and is not sure what he will do until he is eligible for Medicare later this year. “We’re At first, people delayed medical care for fear of catching Covid.

Fred Trotter on Data Journalism and Cybersecurity — Harlow on Healthcare

Health Blawg

Fred’s shorthand definition: “Using FOIA requests and other sorts of collaborations to get covered-over data out of the realm of the useless and into the realm of the useful.” 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.

The The Five Biggest Areas of Opportunity for Digital Health

The Digital Health Corner

One early definition of Artificial Intelligence (AI) in medicine (1984) was “…the construction of AI programs that perform diagnosis and make therapy recommendations. Today a broader definition may be applied: “the simulation of human intelligence processes by machines, especially computer systems. Digital health is unquestionably becoming part of healthcare lexicon and fabric. Electronic health records (EHRs) and personal fitness trackers have helped create awareness through use.

Fred Trotter on Data Journalism and Cybersecurity — Harlow on Healthcare

Health Blawg

Fred’s shorthand definition: “Using FOIA requests and other sorts of collaborations to get covered-over data out of the realm of the useless and into the realm of the useful.”

Fred Trotter on Data Journalism and Cybersecurity — Harlow on Healthcare

Health Blawg

Fred’s shorthand definition: “Using FOIA requests and other sorts of collaborations to get covered-over data out of the realm of the useless and into the realm of the useful.”

Costs, Consumerism, Cyber and Care, Everywhere – The 2019 Health Populi TrendCast

Health Populi

Employers will endeavor to artfully design consumer-directed benefit plans (CDHPs) that nudge insured workers toward healthier habits, while integrating a broader definition of wellness. Today is Boxing Day and St.

Fred Trotter on Data Journalism and Cybersecurity — Harlow on Healthcare

Health Blawg

Fred’s shorthand definition: “Using FOIA requests and other sorts of collaborations to get covered-over data out of the realm of the useless and into the realm of the useful.” 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

Fred’s shorthand definition: “Using FOIA requests and other sorts of collaborations to get covered-over data out of the realm of the useless and into the realm of the useful.” 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

Fred’s shorthand definition: “Using FOIA requests and other sorts of collaborations to get covered-over data out of the realm of the useless and into the realm of the useful.” 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.

Telehealth and the CHRONIC Act of 2017 (S. 870)

South Central Telehealth Resource Center

House of Representatives, allows for an expansion of telehealth/telemedicine coverage under the Medicare Advantage Plan B. While the act does not require a Medicare Advantage Plan to offer additional telehealth services, it does allow the option. Medicare Participants.

Out-of-Pocket and Prescription Drug Costs – Connecting Digital Health Dots at CES 2020

Health Populi

For overall healthcare reform, the plurality of Americans prefer improving the current system (that is, building on the Affordable Care Act) versus repealing and replacing the ACA or adopting a Medicare for All plan.

Health Consumer Behaviors in the U.S. Stall, Alegeus Finds in the 2019 Index

Health Populi

While two-thirds of consumers say they understand their insurance coverage, only one-half of them can correctly answer questions about the definition of premiums and deductibles. That’s in addition to what Americans had already saved into Medicare. Add patients to that definition.

While Costs Are A Top Concern Among Most U.S. Patients, So Are Challenges of Poverty, Food, and Housing

Health Populi

While a “single payer health care system” was favored by 41% in terms of a candidate’s position, 77% of people could not agree on a definition for what “single payer” means in a U.S.

COVID-19 presents a new chance to make telehealth accessible to the underserved

Healthcare IT News - Telehealth

It has broadened the definition of "vulnerable population" to include elderly people, those with chronic illnesses, people experiencing domestic violence, healthcare frontline workers and others.

The successes – and pitfalls – of using telehealth for home-based primary care

KatJercich

"It is definitely helpful to have someone there who understands technology who can troubleshoot with you," said A.

South Central Legislative/Regulatory Update – February 2018

South Central Telehealth Resource Center

Revises the provision which authorizes health care providers to offer telemedicine services; provides definitions and conditions on providers offering telemedicine services; authorizes the state board of medical licensure to promulgate rules relating to telemedicine with certain exceptions.

Senate HELP Committee weighs the future of telehealth

Healthcare IT News - Telehealth

advocated for two particular policy changes to be made permanent: the originating site rule, allowing physicians to be reimbursed for telehealth appointments wherever a patient is located, including a patient's home, and the expansion of Medicare- and Medicaid-reimbursable telehealth services.

Universal Health Care and Financial Inclusion – Not Mutually Exclusive

Health Populi

government (which offers several flavors of plans through the VA, Tricare for active military, Medicare for aging people and Medicaid for people with low-incomes) or private sector employers, unions, and other insurance-conveners.

Essential Telemedicine Terms Clinicians Should Know

Enzyme Health

CMS : Stands for the Centers for Medicaid and Medicare Services. CMS is the federal agency that administers HIPAA standards and develops Medicaid and Medicare reimbursement policies for telemedicine. Applying for telemedicine jobs and want to stand out?

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 .

South Central Legislative/Regulatory Update – May 2018

South Central Telehealth Resource Center

in committee Provides that health insurance companies and employee benefit plans may limit telemedicine coverage to health care providers in network with the plan instead of in a telemedicine network approved by the plan; revises the definition of store and forward telemedicine services for the purposes of coverage and reimbursement for those services; revises the criteria for qualifying patients for remote patient monitoring services.

South Central Legislative/Regulatory Update – June 2018

South Central Telehealth Resource Center

in committee Provides that health insurance companies and employee benefit plans may limit telemedicine coverage to health care providers in network with the plan instead of in a telemedicine network approved by the plan; revises the definition of store and forward telemedicine services for the purposes of coverage and reimbursement for those services; revises the criteria for qualifying patients for remote patient monitoring services.

South Central Legislative/Regulatory Update – March & April 2018

South Central Telehealth Resource Center

Mississippi HB 799 1/30/18: Died in committee Provides that health insurance companies and employee benefit plans may limit telemedicine coverage to health care providers in network with the plan instead of in a telemedicine network approved by the plan; revises the definition of store and forward telemedicine services for the purposes of coverage and reimbursement for those services; revises the criteria for.

South Central Legislative/Regulatory Update – March 2018

South Central Telehealth Resource Center

Provides that health insurance companies and employee benefit plans may limit telemedicine coverage to health care providers in network with the plan instead of in a telemedicine network approved by the plan; revises the definition of store and forward telemedicine services for the purposes of coverage and reimbursement for those services; revises the criteria for qualifying patients for remote patient monitoring services.

Telemedicine triage kiosks reduce ER visits by 11% for ACO

Healthcare IT News - Telehealth

The Alliance for Integrated Care of New York (AICNY) oversees the healthcare needs of roughly 6,200 dually eligible Medicare and Medicaid beneficiaries with intellectual and developmental disabilities (IDD).

The Future of Healthcare: Telehealth. Here’s Why You Need to Consider Telemedicine in 2019

Continue Education Journal

Telehealth and Telemedicine Definition. Centers for Medicare & Medicaid Services (CMS), which will help ensure providers have the ability to set patients up with proper at-home treatment and monitoring systems.

South Central Legislative/Regulatory Update – November 2017

South Central Telehealth Resource Center

This bill would create the Telemedicine Act; amend the definition of telemedicine and originating site; addresses requirements of a professional relationship when using telemedicine; adds standards for the appropriate use of telemedicine; address insurance coverage of telemedicine; and for other purposes. Provides a definition for telemedicine and allows the required face-to-face encounter for care coordinators to take place over telemedicine.

Virtual Reality Applications in Workers’ Compensation Reviews

Advanced Medical Reviews

For years, many insurance carriers offered limited coverage options for such telehealth consultations conducted via phone/VoIP or video conference, for several reasons, including: Lack of a clear definition of what services qualified as telemedicine. Restrictive telehealth payment rules under programs like Medicare. VR can be the next step in such high-definition telemedicine.

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 .