http://www.healthcaredive.com/news/slavitt-details-macra-commentators-5-priority-areas-1/423138/
Tag Archives: Health Policy
Chronic Care Management Services
Click to access ChronicCareManagement.pdf
The Centers for Medicare & Medicaid Services (CMS) recognizes care management as one of the critical components of primary care that contributes to better health and care for individuals, as well as reduced spending. Beginning January 1, 2015, Medicare pays separately under the Medicare Physician Fee Schedule (PFS) under American Medical Association Current Procedural Terminology (CPT) code 99490, for non-face-to-face care coordination services furnished to Medicare beneficiaries with multiple chronic conditions.
CPT 99490 is defined as follows: 99490 Chronic care management services, at least 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month, with the following required elements:
> Multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient,
> Chronic conditions place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, `
> Comprehensive care plan established, implemented, revised, or monitored.
FDA temporarily halts blood donation in two Florida counties over Zika fears
The U.S. Food and Drug Administration is asking blood centers in two Florida counties to immediately stop collections. The counties are investigating possible local transmission of Zika virus.
In a notice sent to blood centers and posted on the agency’s website Wednesday evening, the FDA said it is requesting all blood centers in Miami-Dade or Broward counties to “cease collecting blood immediately” until those facilities can test individual units of blood donated in those two counties with a special investigational donor screening test for Zika virus or until the establishments implement the use of an approved or investigational pathogen-inactivation technology.
The action by the FDA comes as health officials in Florida said Thursday they were continuing to investigate two Zika cases that could have been spread by local mosquitoes, in addition to two similar cases they announced last week. Health officials have not confirmed whether any of the infected individuals acquired the virus from local mosquitoes, but it seems increasingly likely.
“These may be the first cases of local Zika virus transmission by mosquitoes in the continental United States,” the FDA said in its notice and in a media statement Thursday. It said it was making the request of blood-collection establishments “in consideration of the possibility of an emerging local outbreak of Zika virus, and as a prudent measure to help assure the safety of blood and blood products.”
Hospitals show some benefit from ACA
The Affordable Care Act has cut hospital charity care and bad debt expenses, but opponents say it is not enough to contain healthcare costs.
15 things for healthcare leaders to know about Obama’s 2017 budget
Anthem’s Good, Bad and Ugly News
Anthem had some good headlines on Wednesday. The insurer reported second-quarter earnings and revenue that topped estimates, with the latter jumping 7.2 percent from a year earlier. It expects to insure more people than it initially forecast this year, after surprisingly robust growth in its Medicaid business.
But beneath the good, there was also bad and ugly.
Caring for High-Need, High-Cost Patients—An Urgent Priority
Meaningful improvement in the health system will require improvement in care for those patients using it the most: people with multiple chronic conditions. Within this clinically diverse group are patients who remain stable for years with appropriate treatment, others who live with extreme functional limitations, and still others with persistent behavioral health challenges or related social needs, like housing or food, that exacerbate their conditions. Care for these high-need, high-cost patients is expensive: despite comprising just 5 percent of the U.S. population, they account for 50 percent of the nation’s annual health care spending.
How Uber will Redefine Healthcare
http://altarum.org/health-policy-blog/how-uber-will-redefine-healthcare
My Twitter pal and founding partner of Forthright Health Management, Tom Valenti, wrote in TechCrunch that “there will never be an Uber for healthcare” because “[h]ealthcare is not a transaction business; it is a relationship business.”
I’ll respectfully disagree: Healthcare “Ubers” are already proliferating and will ultimately reshape 21st-century medicine. The more aspects of healthcare we can shift from relationship to transaction, the better life will be for patients and doctors alike.
C-suite feels ripple effect from Medicaid expansion, study says
http://www.healthcarefinancenews.com/news/c-suite-feels-ripple-effect-medicaid-expansion-study-says
Medicaid expansion is making a difference as to whether hospitals are investing in clinics, new equipment and hiring new staff, or looking at the status quo and layoffs, according to a recent report by Georgetown University Health Policy Institute.
Hospitals in Medicaid expansion states have realized a drop in uncompensated care; an increase in institutional financial security; new community efforts to integrate and improve care; and innovative programs to expand access to specialists, according to the study.
CEOs who head hospitals in both expansion and non-expansion states said they saw a drop in uninsured rates in expansion states that was not as dramatic in non-expansion states.
This has translated to a decline in uninsured patient stays by close to 40 percent. Non expansion states reported a decline of 2.9 percent.
Uninsured would drop by millions, enrollment would swell if Medicaid expansion holdouts opted in
Nineteen states have yet to expand their Medicaid programs under theAffordable Care Act, and a new study from the Robert Wood Johnson Foundation shows just how much enrollment would increase if they did: 7.8 to 8.8 million, while the number of uninsured would decline between 4.1 and 5 million, the research found.
That’s in addition to about 6.9 million people who would be subtracted from the ranks of the uninsured under the major coverage provisions of the ACA.
More than half of these people would be in three states: Texas (1.2 million), Florida (877,000), and Georgia (509,000). More than four-fifths of the uninsured people gaining Medicaid eligibility would be adult without children, while about 48 percent of the uninsured gaining eligibility would be white non-Hispanic; 52 percent are working either full- or part-time.
HENRY KOTULA 