Medicare Next Generation ACO Model Telehealth Expansion Waiver

TeleMental Health blog

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).

CMS launches first-ever consumer-facing app, for Original Medicare beneficiaries

Mobi Health News

The app lets those on Medicare search for products and services to see if they are covered

CMS launches Medicare info mobile app

Morning eHealth

Optum comes back swinging in employment war — Comments on EHRs and clinician burden

EHR 117

The Political Plausibility of Medicare for All

Electronic Health Reporter

The article The Political Plausibility of Medicare for All appeared first on electronichealthreporter.com. Editorial Ken Perez Medicare for All OmnicellThis content is copyrighted strictly for Electronic Health Reporter. By Ken Perez, vice president of healthcare policy, Omnicell, Inc.

Nearly Half of Adults Unfamiliar with ‘Medicare for All’

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. 13-16, 2018, surveyed 1,021 interviewees on their perception of Medicare for All proposals.

Apple spreading deeper into Medicare Advantage

Morning eHealth

Verma’s extremely online price transparency push — Event dispatches

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.

Payers, providers push back on Democrats' Medicare buy-in plan

FierceHealthIT

The Medicare at 50 Act, introduced earlier this week, is already getting pushback from healthcare organizations that were hoping to either expand Medicare options to all or, on the flip side, keep the coverage primarily for those 65 and over

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

Study: More Medicare Patients Dying At Home

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% The growth of Medicare Advantage as a program (it accounts for a third of Medicare enrollees and spending), and the 9.3%

CMS unveils app for Medicare beneficiaries to view coverage details

FierceHealthIT

CMS' new "What's covered" app, available on iOS and Android devices, allows users to quickly look up whether Medicare covers a certain device or procedure

CMS Proposes to Expand Telehealth Benefits Under Medicare Advantage Plans

Healthcare Informatics

CMS is proposing to implement several sections of the Bipartisan Budget Act of 2018, including expanding telehealth benefits under Medicare Advantage plans

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. That's $1.1 billion more than CMS estimates

Medicare Advantage insurtech startup Clover Health raises $500M

Mobi Health News

The Greenoaks Capital-led round is expected to close within the next couple of weeks

CMS finalizes rule for remote patient monitoring reimbursement under Medicare

Mobi Health News

CMS Administrator Seema Verma said that the remote monitoring change and others would promote care innovation and reduce provider burden

‘Medicare-for-all’ compounds Medicare’s current problems, Verma says

FierceHealthIT

Echoing her boss’s op-ed last week, Centers for Medicare & Medicaid Services Administrator Seema Verma devoted an unusually long time in one speech to why a popular progressive proposal would not work

4 in 10 Medicare beneficiaries expected to be on Medicare Advantage plans by 2028

FierceHealthIT

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

Health Is Social – The Social Determinants of Health at HIMSS19

Health Populi

To mitigate SDoH risks for older Americans, Medicare has begun to pay for services that promote coordinated care. In the health care world, it is now commonly accepted that genes contribute less than half of the influence on peoples’ health status.

CMS looks to expand Medicare coverage to CAR-T therapy 

FierceHealthIT

The Centers for Medicare & Medicaid Services plans to cover an emerging immunotherapy for cancer patients, it announced on Friday. CMS intends to allow Medicare to pay for chimeric antigen receptor (CAR) T-cell therapy, in which oncologists use a patient’s own immune system to attack a tumor

Medicare Advantage Plans Grow With Star Ratings

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

The Centers for Medicare and Medicaid Approved Separate Reimbursements for Non-Traditional Patient Visits

eVisit

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 ”.

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.

Big changes are coming to Medicare reimbursement for connected health

Mobi Health News

At HIMSS19, ACT | The App Association's Brian Scarpelli will lay out the details of what he calls a "sea change" in CMS' policy toward remote patient monitoring

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.

CMS planning to expand supplemental benefits in Medicare Advantage for members with chronic illness 

FierceHealthIT

CMS is looking to further expand options for Medicare Advantage plans to provide supplementary benefits to beneficiaries with chronic conditions.

AHA report: Medicare, Medicaid underpaid hospitals by $76B in 2017 

FierceHealthIT

Many hospitals are making significant investments in community programs, despite losing nearly $77 billion in Medicare and Medicaid payments in 2017, according to new data from the American Hospital Association.

Medicare Payment Suspension & Termination

Healthcare Guys

Specifically, special attention should be paid to the business’s billing practices, and current Medicare policies and procedures concerning coverage and claims determinations To safeguard your business from payment interruption, providers and suppliers should ensure they have effective compliance measures in place.

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. ” Increasing costs for prescriptions is creating a long-term financial impact on Medicare Part D and its beneficiaries.

Why Lyft is making Medicare Advantage a key focus of its healthcare work

FierceHealthIT

Ride-hailing service Lyft has been in the healthcare space for the past several years, and it sees Medicare Advantage plans as a key demographic for its health platform

Medicare, Medicaid better than private insurers at containing costs, study finds 

FierceHealthIT

Medicare and Medicaid are better than private insurers at keeping spending per beneficiary low, a finding that has crucial implications for the current health policy debate, according to a new report.

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

Telehealth Blog

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

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

Health Populi

Greater attention paid to the social determinants of health, by payors (both public in Medicaid and Medicare, and in private sector benefit plans) will promote peoples’ access to care, services and social support outside of traditional, legacy healthcare nodes.

Medicare payments won’t cover costs for many physician practices in 2019, poll finds

FierceHealthIT

Medicare reimbursement isn’t cutting it for many physician practices. Some 67% of medical practices said that 2019 Medicare payment rates will not cover the cost of their delivering care to patients, according to an MGMA Stat poll

UnitedHealthcare expands digital data collection for Medicare beneficiares

FierceHealthIT

UnitedHealthcare announced it will increase the amount of data collected from digital devices as a tool against managing chronic illnesses

Insurers point to Medicare Advantage as they boast about growth

FierceHealthIT

Morgan Healthcare Conference this week: the boost from Medicare Advantage A common theme among insurers speaking at the J.P.

Federal watchdog: Nearly half of Medicare patients in long-term-care hospitals experienced harm

FierceHealthIT

Nearly half of Medicare patients in long-term-care facilities have experienced some type of harm as the result of their care, endangering their health and increasing Medicare costs, according to a report from a government watchdog

DOJ joins lawsuit accusing Sutter Health of Medicare Advantage fraud

FierceHealthIT

Federal prosecutors have intervened in a newly unsealed whistleblower lawsuit accusing Sutter Health of submitting unsupported diagnosis codes to Medicare Advantage plans, which inflated payments. The lawsuit comes weeks after DaVita's medical group paid $270 million to resolve similar allegations

UnitedHealthcare, Peerfit push deeper into Medicare Advantage markets, and more digital health news briefs

Mobi Health News

Also: Smoking cessation app trial wins $2.7 million research grant; favorable study results for One Drop

CMS appeals Medicare Advantage overpayment ruling

FierceHealthIT

A nuanced legal battle over Medicare Advantage overpayments rages on. CMS will appeal a September ruling invalidating a 2014 rule with huge implications for insurers, including UnitedHealth

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.