Medicare

CMS promises a plan for Medicare to cover coronavirus vaccine

  • by

Medicare doesn’t currently cover drugs approved under emergency use designations. But  CMS Administrator Seema Verma said the agency was coming up with a plan to make sure Medicare beneficiaries were covered once a coronavirus vaccine is developed.

Humana, Fresenius Medical Care Expand Partnership to Improve Care Coordination for Medicare Advantage Members

  • by

What You Should Know: – Humana Inc. and Fresenius Medical Care North America (FMCNA) today announced an agreement to broaden their collaboration toward improving the health of eligible Humana Medicare Advantage members – The agreement between Humana and Fresenius Medical Care North America goes into… Read More »Humana, Fresenius Medical Care Expand Partnership to Improve Care Coordination for Medicare Advantage Members

Innovaccer Unveils Risk Adjustment Solution For Improved Coding Accuracy

  • by

What You Should Know: – Innovaccer unveils new risk adjustment solution to help providers better segment their population to refine the risk scoring process and improve coding accuracy and efficiency, thereby improving performance on risk-based contracts. – The solution utilizes Artificial Intelligence (AI) and Natural… Read More »Innovaccer Unveils Risk Adjustment Solution For Improved Coding Accuracy

Half of Patients Referred to Home Health Don’t Receive Services — But Providers Can Change That

  • by

Home health is often utilized as a recovery tool when patients transition out of the hospital because of its ability to improve outcomes. But many of the Medicare beneficiaries who receive referrals after being discharged aren’t actually receiving these services. Overall, the past several decades… Read More »Half of Patients Referred to Home Health Don’t Receive Services — But Providers Can Change That

Lower Flu Vaccination Rates Among Black, Hispanic, and Low-Income Seniors Suggest Challenges for COVID-19 Vaccination Efforts

  • by

People 65 and older, who have been hardest hit by COVID-19 in terms of hospitalizations and deaths, are also at high risk of severe flu illness and are more likely to die of the flu than younger people. This analysis explores variation in the rate… Read More »Lower Flu Vaccination Rates Among Black, Hispanic, and Low-Income Seniors Suggest Challenges for COVID-19 Vaccination Efforts

Revel, NovuHealth Merge to Create Largest Healthcare Member Engagement Platform

  • by

What You Should Know: – NovuHealth and Revel merge to bring together NovuHealth’s personalized healthcare loyalty programs with Revel’s applied behavioral research and health action technologies.  – Together, Revel and NovuHealth work with more than 50 healthcare organizations, including seven of the top 10 largest… Read More »Revel, NovuHealth Merge to Create Largest Healthcare Member Engagement Platform

Three reasons why repealing the Part D non-interference clause is a bad idea

  • by

For more than a decade, Medicare Part D has provided seniors affordable and comprehensive prescription drug coverage. Its unique, market-based structure has kept overall Part D program costs far below initial projections, coming in at nearly $350 billion less than the Congressional Budget Office’s initial… Read More »Three reasons why repealing the Part D non-interference clause is a bad idea

Independence Blue Cross, Signify Launches Social Determinants of Health Network in Philly

  • by

What You Should Know: – Independence Blue Cross and Signify Health launches social determinants of health network, CommunityLink to connect data from multiple CBOs to integrate social directly into medical care in the Philadelphia area. – CommunityLink represents one of the first examples nationwide of… Read More »Independence Blue Cross, Signify Launches Social Determinants of Health Network in Philly

Trump Is Sending Fast, Cheap COVID Tests to Nursing Homes — But There’s a Hitch

  • by

The Trump administration’s latest effort to use COVID-19 rapid tests — touted by one senior official as a “turning point” in arresting the coronavirus’s spread within nursing homes — is running into roadblocks likely to limit how widely they’ll be used. Federal officials are distributing… Read More »Trump Is Sending Fast, Cheap COVID Tests to Nursing Homes — But There’s a Hitch

GOP Senate Ad Misrepresents Mont. Governor’s Stance on Rural Hospitals, Public Option

  • by

An attack ad, which was released in mid-July, states that Montana Gov. Steve Bullock, a Democratic candidate for the Senate, supports a government-run health care program that would wreak havoc on the state’s health care infrastructure. “Bullock’s health care plan will force rural hospitals to… Read More »GOP Senate Ad Misrepresents Mont. Governor’s Stance on Rural Hospitals, Public Option

OIG: Medicare Overpaid $267M for Hospital In-Patient Claims with Post-Acute Transfers to Home Health Services

  • by

Hospitals improperly coding for post-discharge services contribute to hundreds of millions of dollars in Medicare overpayments. And the majority of incorrect payments are often related to home health services. That’s according to a new audit report from the Department of Health and Human Services (HHS)… Read More »OIG: Medicare Overpaid $267M for Hospital In-Patient Claims with Post-Acute Transfers to Home Health Services

Business Is Booming for Dialysis Giant Fresenius. It Took a $137M Bailout Anyway.

  • by

As the coronavirus pandemic paralyzed most nonemergency medical practices this spring, the dialysis business, vital to the survival of patients with kidney disease, rolled ahead and in some cases grew. Yet when the Trump administration sent billions in federal relief funds to medical organizations, at… Read More »Business Is Booming for Dialysis Giant Fresenius. It Took a $137M Bailout Anyway.

COVID-19 Underscores Why Certain Aspects of the American Healthcare System Should Change Forever

  • by

Irv Lichtenwald, President & CEO of Medsphere Systems Corporation In the late 1940s, the United Kingdom was busily reassembling country and what remained of the empire in the aftermath of World War II. Among many revelations, the war had convinced Britain’s leaders of the need… Read More »COVID-19 Underscores Why Certain Aspects of the American Healthcare System Should Change Forever

Primary care startup Oak Street Health goes public for $328M

  • by

Oak Street Health, which operates primary care centers for Medicare patients, went public on Thursday for $328 million. Its capitation payment model has helped the company continue on where many clinics have struggled during the Covid-19 pandemic.

Trump executive order targets rural telehealth expansion

  • by

The executive order would call on the Department of Health and Human Services to develop a new pilot payment model for rural hospitals, and would set up a task force to improve broadband infrastructure in rural communities.

Home-Based Medical Care Can Reduce Hospitalizations and Lower Costs — But It’s Still Underutilized

  • by

While home-based medical care has been shown to reduce hospitalization rates and lower costs for both homebound and non-homebound populations alike, it continues to be drastically underutilized in the current health care ecosystem. As a result, there are millions of older Americans — especially those… Read More »Home-Based Medical Care Can Reduce Hospitalizations and Lower Costs — But It’s Still Underutilized

Humana Helps Fast-Track In-Home Primary Care Company Heal’s Growth with $100M Investment

  • by

Health and well-being company Humana Inc. (NYSE: HUM) has spent the past few years adding to its health care services portfolio while aggressively investing around a home-based care strategy. The Louisville, Kentucky-based company has now revealed its latest step in that direction. On Wednesday, Humana… Read More »Humana Helps Fast-Track In-Home Primary Care Company Heal’s Growth with $100M Investment

W2O Acquires Discern Health to Strengthen Value-Based Care Capabilities

  • by

What You Should Know: – W2O announced today the acquisition of Discern Health, a leading healthcare consultancy based in Washington, DC, and Baltimore, to strengthen its strategic capabilities in assisting clients with critical healthcare policy trends and value-based reimbursement models. – Discern Health brings experts with… Read More »W2O Acquires Discern Health to Strengthen Value-Based Care Capabilities

How ADT-Based E-Notifications Can Enable Better Safety for COVID-19 Patients

  • by

Jay Desai, CEO & Co-Founder, PatientPing As COVID-19 continues to impact the country, providers across the continuum face new challenges delivering care and ensuring safety for their patients and themselves.  During this period, sharing real-time information about patients’ care encounters across provider types and care… Read More »How ADT-Based E-Notifications Can Enable Better Safety for COVID-19 Patients

Ambulance Crews and In-Home Care Providers Seek Collaboration — Not Competition

  • by

As hospitals continue to experience overcapacity challenges due to the COVID-19 emergency, 911 ambulance crews and community paramedics have found themselves treating more patients at home. Historically, ambulance crews and community paramedics — both of which operate in the emergency medical services (EMS) space —… Read More »Ambulance Crews and In-Home Care Providers Seek Collaboration — Not Competition

House bill would cement Medicare telehealth changes

  • by

A bill introduced to the U.S. House of Representatives on Thursday would permanently lift site restrictions for Medicare patients to access telehealth. During the pandemic, several restrictions on where telehealth visits could be conducted and what services were eligible were temporarily lifted.

How Could the Price of Remdesivir Impact Medicare Spending for COVID-19 Patients?

  • by

This brief discusses how drugs provided in inpatient hospital settings are covered and reimbursed for beneficiaries in traditional Medicare under current law. This is relevant for Medicare spending on COVID-19 patients who receive Gilead’s new antiviral drug remdesivir. We discuss the implications for hospitals and… Read More »How Could the Price of Remdesivir Impact Medicare Spending for COVID-19 Patients?

8 in 10 Consumers Stated COVID-19 Made Telehealth “Indispensable” in Healthcare Delivery

  • by

What You Should Know: – 8 in 10 consumers said COVID-19 made telehealth “an indispensable part of the healthcare system, according to a new study commissioned by Change Healthcare. – 2020 Change Healthcare – Harris Poll Consumer Experience Index reveals 65% said they plan to… Read More »8 in 10 Consumers Stated COVID-19 Made Telehealth “Indispensable” in Healthcare Delivery

We Are in Store for the Greatest Change to Our Healthcare System Since the Affordable Care Act. Here’s Why.

  • by

By LOGAN CHO The COVID-19 pandemic has been harsher and lasted longer than many of us would have predicted. While our media has been inundated with updates on death tolls and economic depression, there has been little conversation of healthcare beyond the era of COVID-19.… Read More »We Are in Store for the Greatest Change to Our Healthcare System Since the Affordable Care Act. Here’s Why.

Doctor On Demand Raises $75M to Expand Comprehensive Virtual Care Platform

What You Should Know – Doctor On Demand raises $75M in Series D funding led by General Atlantic to expand comprehensive virtual care. – Doctor On Demand is seeing record usage this year – up 139% – for COVID-19 screenings, routine health issues, chronic conditions and behavioral health. San Francisco, CA-based Doctor… Read More »Doctor On Demand Raises $75M to Expand Comprehensive Virtual Care Platform

Comparing Private Payer and Medicare Payment Rates for Select Inpatient Hospital Services

This issue brief analyzes hospital payments paid by private payers and by Medicare for a selection of inpatient services, including services requiring similar inpatient treatments to those used for COVID-19. It finds that private insurance payments for such services vary widely and exceed Medicare payment… Read More »Comparing Private Payer and Medicare Payment Rates for Select Inpatient Hospital Services