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 For a long time, Medicare has had a reputation for being bureaucratic, lethargic, wasteful, and outdated.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. MORE
Here’s one description about the chain’s plans to use $200 mm to expand in Florida (THINK: the state will be home to 4,5 million people age 65 and over in 2020, potential candidates for Humana’s Medicare programs. Walmart has been a health/care destination for many years. MORE
The Medicare Payment Advisory Commission shied away from recommending policymakers expand telehealth coverage for specific services and instead urged CMS to evaluate cost, access and quality by launching pilot projects through CMMI MORE
Buried underneath changes to the Meaningful Use program, a newly proposed hospital payment rule includes the possibility of more stringent requirements that would require providers to share data to participate in the Medicare program. Experts said the agency could also leverage that approach to give TEFCA more teeth MORE
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 MORE
What ONC is up to — HITAC task force on interoperability to get underway MORE
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 MORE
The Department of Justice has asked Anthem for more information about its Medicare Advantage and Part D plans as part of an ongoing probe dating back to 2016. Anthem says the inquiry is part of an investigation into other Medicare Advantage health plans, as well as providers and vendors MORE
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Department of Health and Human Services (HHS) – including its Centers for Medicare & Medicaid Services (CMS), Office of the National Coordinator for Health Information Technology (ONC), and National Institutes of Health (NIH) – as well as the U.S. Medicare’s Blue Button 2.0 is a new and secure way for Medicare beneficiaries to access and share their personal health data in a universal digital format. Medicare’s Blue Button 2.0 MORE
Responding to a request for information from CMS, the American Hospital Association said it "strongly opposes" revising Medicare Conditions of Participation to include interoperability requirements. The hospital association argued that interoperability is difficult for surveyors to measure and unfairly targets hospitals for data sharing problems that span the healthcare ecosystem MORE
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. MORE
Cerner will become a minority owner in Lumeris' parent company as part of a 10-year strategic partnership focused on value-based care payment arrangements, particularly in the Medicare Advantage space. The two companies plan to release a new joint offering, Maestro Advantage, this year MORE
58 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. are on Medicaid and/or Medicare. The post HEART Act Targets Medicare Limits on Telehealth appeared first on American Well. MORE
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. MORE
CMS is making good on its promise to release encounter data that it collects from Medicare Advantage plans. The agency was scheduled to release the data last year, but concerns over accuracy caused them to pull back, disappointing researchers. CMS also announced that it will publicly release data for Medicaid and CHIP plans next year MORE
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Lawmakers on an influential House committee appear to be looking at Medicare reimbursement as the main culprit of opioid overprescribing. Payment changes for alternative treatments may be in order, and providers say they are "inadequately compensated" for time spent screening patients for addiction or checking drug registries MORE
41 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 MORE
Financial health Health Consumers Health costs Health Economics Health policy Heart health Medicare Medicines Mental health Money and health Obesity Personal health finance Pharmaceutical Prescription drugs Prevention Public health Specialty drugs TransparencyThe U.S. MORE
"Until a deal is done, it's not done," Centene CEO Michael Neidorff said during an earnings call Tuesday in response to a question about inorganic Medicare growth. Company executives appeared unfazed about the current risk adjustment freeze and looming competition on the ACA marketplace MORE
34 A new study from Johns Hopkins University indicates that not enough Medicare patients undergo minimally invasive surgeries, despite better outcomes, fewer readmissions and lower costs. Researchers said that the findings indicate there is an opportunity for Medicare and other payers to spend healthcare dollars more wisely so that they reward high-value care over low-value care MORE
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It’s February 1st, which marks the first of 28 days of American Heart Month – a time to get real, embrace, learn about, and engage with heart health. Heart disease kills 610,000 people in the U.S. every year, equal to 1 in 4 deaths in America. MORE
Medicare Related Topics 
BHM Healthcare Solutions
AUGUST 7, 2018
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.
BHM Healthcare Solutions
JUNE 26, 2018
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% The growth of Medicare Advantage as a program (it accounts for a third of Medicare enrollees and spending), and the 9.3%
BHM Healthcare Solutions
AUGUST 7, 2018
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.
The cHealth Blog
NOVEMBER 16, 2017
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.
BHM Healthcare Solutions
APRIL 10, 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. Financial Medicare and Medicaid Medicaid Medicare payment models Value Based Payments
Morning eHealth
JULY 16, 2018
What ONC is up to — HITAC task force on interoperability to get underway
FierceHealthIT
AUGUST 9, 2018
Much of the House Republican conference is having second thoughts about closing a doughnut hole for Medicare Part D enrollees, inspiring the AARP to weigh in
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
Mobi Health News
AUGUST 15, 2018
Oscar says it uses technology to lower cost: More than 60 percent of member interactions with health systems are virtual
Health Populi
MARCH 27, 2018
The latest data on health care costs in retirement was published by EBRI earlier this year in their report , Savings Medicare Beneficiaries Need for Health Expenses: Some Couples Could Need as Much as $370,000, Up from $350,000 in 2016.
FierceHealthIT
JUNE 25, 2018
Responding to a request for information from CMS, the American Hospital Association said it "strongly opposes" revising Medicare Conditions of Participation to include interoperability requirements. The hospital association argued that interoperability is difficult for surveyors to measure and unfairly targets hospitals for data sharing problems that span the healthcare ecosystem
FierceHealthIT
APRIL 12, 2018
Medicare Advantage plans have been touted as a way to give more control to seniors, but non-minorities may be reaping most of the benefits. A new report finds that minorities enrolled in MA plans are receiving worse clinical care than white patients, following similar studies
American Well Blog
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. are on Medicaid and/or Medicare. The post HEART Act Targets Medicare Limits on Telehealth appeared first on American Well.
Health Populi
JUNE 7, 2018
Financial health Health Consumers Health costs Health Economics Health policy Heart health Medicare Medicines Mental health Money and health Obesity Personal health finance Pharmaceutical Prescription drugs Prevention Public health Specialty drugs TransparencyThe U.S.
FierceHealthIT
MAY 29, 2018
The Centers for Medicare & Medicaid Services heard both pros and cons on its proposal to allow physicians to bill Medicare patients directly
FierceHealthIT
JULY 12, 2018
A new analysis from Avalere shows Medicare Advantage patients have fewer inpatient stays, ER visits and avoidable hospitalizations than fee-for-service beneficiaries, despite higher rates of social and economic risk factors
FierceHealthIT
MARCH 26, 2018
Despite concerns from industry analysts, Medicare Advantage plans are thriving in the wake of the ACA; a new Kaiser Family Foundation poll suggests support for a "Medicare for all" program is on the rise; plus more health insurance headlines
FierceHealthIT
MAY 11, 2018
The Trump administration has its sights on major changes to Medicare in its quest for lower drug prices, with proposed changes to Part D formularies and increased scrutiny of PBM rebates
ConnectedHealth
MARCH 17, 2017
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.
FierceHealthIT
AUGUST 7, 2018
In a significant move meant to foster competition, allowing Medicare Advantage plans to negotiate Part B drug prices will generate cost savings that they then can pass on to consumers, the agency says
FierceHealthIT
JULY 10, 2018
Most physicians treating Medicare patients don’t know how Medicare is evaluating and paying them, a new study concluded. The survey found that more than 60% of doctors reported little to no familiarity with MIPS
FierceHealthIT
APRIL 26, 2018
The Department of Justice has asked Anthem for more information about its Medicare Advantage and Part D plans as part of an ongoing probe dating back to 2016. Anthem says the inquiry is part of an investigation into other Medicare Advantage health plans, as well as providers and vendors
FierceHealthIT
JULY 30, 2018
The announcement followed two other recent acquisitions by the insurer to boost its MA population, as well as favorable growth in Medicare overall this past quarter
FierceHealthIT
JULY 9, 2018
Cerner will become a minority owner in Lumeris' parent company as part of a 10-year strategic partnership focused on value-based care payment arrangements, particularly in the Medicare Advantage space. The two companies plan to release a new joint offering, Maestro Advantage, this year
FierceHealthIT
MAY 1, 2018
Aetna has added 250,000 Medicare Advantage members on its way to a profitable first quarter as it looks to close a deal with CVS Health. The insurer reported $1.2 billion in net income thanks, in part, to an ACA exchange exit
FierceHealthIT
MAY 2, 2018
A proposed rule change last month would require hospitals to share data as a requirement of participating in Medicare
Health Populi
APRIL 16, 2018
Here’s one description about the chain’s plans to use $200 mm to expand in Florida (THINK: the state will be home to 4,5 million people age 65 and over in 2020, potential candidates for Humana’s Medicare programs. Walmart has been a health/care destination for many years.
FierceHealthIT
JULY 24, 2018
"Until a deal is done, it's not done," Centene CEO Michael Neidorff said during an earnings call Tuesday in response to a question about inorganic Medicare growth. Company executives appeared unfazed about the current risk adjustment freeze and looming competition on the ACA marketplace
FierceHealthIT
AUGUST 13, 2018
The Justice Department selected the cities for the Strike Force's newest division due to the prominence of fraud, including illegal opioid distribution, in the region
FierceHealthIT
MARCH 6, 2018
A new study from Johns Hopkins University indicates that not enough Medicare patients undergo minimally invasive surgeries, despite better outcomes, fewer readmissions and lower costs. Researchers said that the findings indicate there is an opportunity for Medicare and other payers to spend healthcare dollars more wisely so that they reward high-value care over low-value care
Health Populi
JANUARY 31, 2018
It’s February 1st, which marks the first of 28 days of American Heart Month – a time to get real, embrace, learn about, and engage with heart health. Heart disease kills 610,000 people in the U.S. every year, equal to 1 in 4 deaths in America.
FierceHealthIT
APRIL 26, 2018
CMS is making good on its promise to release encounter data that it collects from Medicare Advantage plans. The agency was scheduled to release the data last year, but concerns over accuracy caused them to pull back, disappointing researchers. CMS also announced that it will publicly release data for Medicaid and CHIP plans next year
FierceHealthIT
MARCH 15, 2018
The Medicare Payment Advisory Commission shied away from recommending policymakers expand telehealth coverage for specific services and instead urged CMS to evaluate cost, access and quality by launching pilot projects through CMMI
FierceHealthIT
JUNE 6, 2018
It appears congressional Republicans have received new ammo in their long-term quest to reform the Medicare program following a recent trustees report which found the program has a shorter shelf-life than previously thought
FierceHealthIT
JUNE 1, 2018
Medicare officials recently told insurers to knock off costly "gag clauses" but stopped short of requiring them to lift such restrictions on pharmacists. So how can patients make sure they don't overpay? It's as simple as asking
Medicine and Technology
MARCH 6, 2018
Department of Health and Human Services (HHS) – including its Centers for Medicare & Medicaid Services (CMS), Office of the National Coordinator for Health Information Technology (ONC), and National Institutes of Health (NIH) – as well as the U.S. Medicare’s Blue Button 2.0 is a new and secure way for Medicare beneficiaries to access and share their personal health data in a universal digital format. Medicare’s Blue Button 2.0
FierceHealthIT
JULY 3, 2018
Under a demonstration project, CMS will move ahead with plans to test whether certain Medicare Advantage plans should qualify as an advanced alternative payment model and exempt doctors from MIPS
FierceHealthIT
FEBRUARY 21, 2018
Despite concerns about the quality of Medicare Advantage encounter data, a new JAMA viewpoint piece argues that it's long past time to make that information available to researchers who want to study the ever-growing privatized Medicare program.
FierceHealthIT
APRIL 12, 2018
Lawmakers on an influential House committee appear to be looking at Medicare reimbursement as the main culprit of opioid overprescribing. Payment changes for alternative treatments may be in order, and providers say they are "inadequately compensated" for time spent screening patients for addiction or checking drug registries
FierceHealthIT
APRIL 25, 2018
Buried underneath changes to the Meaningful Use program, a newly proposed hospital payment rule includes the possibility of more stringent requirements that would require providers to share data to participate in the Medicare program. Experts said the agency could also leverage that approach to give TEFCA more teeth
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