News Summary

News Summary 7.21.18

Submitted by hm_admin on Sat, 07/21/2018 - 17:19

Modern HealthcareCMS proposal to bring clarity to Medicare provider application: The CMS announced revisions to the provider Medicare enrollment application to add coherence and a more logical flow. "What CMS is trying to do is achieve several goals, one of them being to stop erroneous enrollment."

Healthcare InformaticsCMS broadened key definition to fit telehealth reimbursement plans: CMS redefined “communication technology-based services” to legally get around previous telehealth reimbursement blockades. The proposed changes will be effective January 1, 2019.

Specialty Pharmacy TimesDrugs with highest spend in Medicare Part D cost rapidly rising: The most expensive drugs in Medicare Part D rose by almost one-third between 2011 and 2015, a new report found.  Though fewer patients use these drugs, costs continue to soar, estimated to reach $40 billion annually by 2020.

News Summary 7.14.18

Submitted by hm_admin on Sun, 07/15/2018 - 06:36

New York Times: Irregular and unpredictable drug prices -- A new study analyzed the disparities in drug prices city-to-city across the nation. While some price hikes were unsurprising, like in New York and San Francisco, others were more unpredictable, even finding vastly different drug prices from pharmacies on the same block.

Health Payer Intelligence: Star ratings impacted by population economic status--Health plan members’ socioeconomic backgrounds affect Medicare Advantage star ratings, new research found. In the current ratings system, plans that serve “low income, medically complex, or socioeconomically vulnerable individuals,” may unwittingly be prone to lower star ratings. 

mHealth Intelligence: Telehealth reimbursements included in CMS 2019 proposal—Virtual care service opportunities, including virtual check-in services, remote evaluation of patient-submitted videos and images, and expanded reimbursements, were all included in the CMS proposal for next year. "Today is a huge win for patients and providers as CMS is proposing historic changes to modernize Medicare and restore the doctor-patient relationship," said CMS Administrator Seema Verma.

News Summary 6.29.18

Submitted by hm_admin on Fri, 06/29/2018 - 07:57

HealthPayerIntelligence: Low customer satisfaction for Medicare Advantage -- Uncoordinated communication and little help managing expenses led to low customer satisfaction for Medicare Advantage. With the 7.5 percent growth in the Medicare Advantage market since last year, plans likely aren’t equipped to meet member growth, demands and expectations.

Kaiser Health News: Gawande chosen to lead venture -- Dr. Atul Gawande was tapped last week to lead the Amazon, Bershire-Hathway and JP Morgan backed health care venture. As an acclaimed surgeon, writer and researcher, he plans to help health professionals, “make it simpler to do the right thing.”

New York Times: Insulin cutback by patients to save cost -- One in four patients with diabetes admitted to cutting back on insulin use because of cost, according to a new study from Yale University. Those with Type 1 diabetes die within a week or so without insulin. With no generic version of insulin, many are left with difficult choices around their finances and their health.