Healthcare reform in the United States

MetroPlusHealth Ranks #1 in 2020 Medicaid Quality Incentive Program

Retrieved on: 
Wednesday, July 14, 2021
Practice Management, Managed care, Other Health, Health, General Health, Women, MEN, Family, Hospitals, Consumer, Parenting, Managed care, Healthcare reform in the United States, Health, Child poverty, Federal assistance in the United States, Medicaid, Presidency of Lyndon B. Johnson, Medi-Cal, United States

In a year that saw unprecedented challenges within the entire health care community, MetroPlusHealth, New York Citys Health Plan, was ranked number one among all 15 New York State Medicaid plans in overall quality, according to the New York State Department of Healths 2020 Quality Incentive results.

Key Points: 
  • In a year that saw unprecedented challenges within the entire health care community, MetroPlusHealth, New York Citys Health Plan, was ranked number one among all 15 New York State Medicaid plans in overall quality, according to the New York State Department of Healths 2020 Quality Incentive results.
  • (Photo: Business Wire)
    As New York City shut down in March of 2020, the staff of MetroPlusHealth pivoted to remote work as entire departments were redeployed.
  • The New York State Quality Incentive program is based on reporting and measurement from medical care in the prior calendar year.
  • A plans score and ranking in the program indicates the quality of care provided to the plans members relative to all plans in the Medicaid Managed Care market.

THRIVE Launched - Improving Healthcare Delivery to the Underserved

Retrieved on: 
Thursday, July 15, 2021
Child poverty, Federal assistance in the United States, Healthcare reform in the United States, Medicaid, Presidency of Lyndon B. Johnson

NAPLES, Fla., July 15, 2021 /PRNewswire/ -- Experienced healthcare strategy, finance, and organizational improvement firm Franz Strategic Solutions has launched its new business venture THRIVE ( http://www.thriveandachieve.com ).

Key Points: 
  • NAPLES, Fla., July 15, 2021 /PRNewswire/ -- Experienced healthcare strategy, finance, and organizational improvement firm Franz Strategic Solutions has launched its new business venture THRIVE ( http://www.thriveandachieve.com ).
  • THRIVE develops targeted programs for underserved communities including Medicaid, uninsured, and those whose well-being is compromised due to lack of access to healthcare and social services.
  • THRIVE has strategically partnered with RDI Healthcare to bring integrated technologyand workflow solutions.
  • Best-in-class Subject Matter Experts (SMEs) are working with THRIVE to ensure that the best solutions are developed for each client.

Blessing Hospital Selects CarePort® to Support Compliance with CMS Patient Event Notification Requirement

Retrieved on: 
Wednesday, July 14, 2021
Health, Technology, Hospitals, Managed care, Software, Networks, Federal assistance in the United States, Healthcare reform in the United States, Presidency of Lyndon B. Johnson, Child poverty, Medicaid, Medicare, Interoperability, Interop, Articles, Health, Computing

Blessing Hospital has selected CarePort Interop to support compliance with the Condition of Participation (CoP) for patient event notifications as part of the Centers for Medicare & Medicaid Services (CMS) Interoperability and Patient Access final rule, which went into effect on May 1, 2021.

Key Points: 
  • Blessing Hospital has selected CarePort Interop to support compliance with the Condition of Participation (CoP) for patient event notifications as part of the Centers for Medicare & Medicaid Services (CMS) Interoperability and Patient Access final rule, which went into effect on May 1, 2021.
  • When we realized our hospital would need an intermediary to support the patient event notification requirement, we turned to our partners at CarePort, said Lea Ann Eickelschulte, Blessing Hospitals chief technology officer.
  • Were excited to expand our partnership with Blessing Hospital, and that they chose CarePort Interop as their compliance solution for CMSs new requirement, said Lissy Hu, M.D., CarePort CEO and founder.
  • CarePort helps providers meet and comply with the patient event notification Condition of Participation as part of the CMS Interoperability and Patient Access final rule and the IMPACT Act.

OptimizeRx Announces Agreement with a Top Pharmaceutical Manufacturer to Use its Evidence-Based Physician Engagement to Solve Lapse in Medical Coverage Barrier for Patients

Retrieved on: 
Wednesday, July 14, 2021
Federal assistance in the United States, Healthcare reform in the United States, Presidency of Lyndon B. Johnson, Liberalism in the United States, Medicare, Government, Health, Public policy

The OptimizeRx platform will leverage RWE to provide visibility to doctors when Medicare patients treatment plans are at risk of lapse due to loss of coverage.

Key Points: 
  • The OptimizeRx platform will leverage RWE to provide visibility to doctors when Medicare patients treatment plans are at risk of lapse due to loss of coverage.
  • Patients often dont know when they are at risk of entering Medicare coverage gaps, resulting in lapses in treatment.
  • Providers dont have real-time visibility on this and, as a result, experience an increased burden in managing treatment plans.
  • Future events and actual results could differ materially from those set forth in, contemplated by, or underlying the forward-looking statements.

Skylight Health Acquires ACO Partners and Enters Value-Based Contracting for Traditional Medicare Patients

Retrieved on: 
Wednesday, July 14, 2021
Healthcare reform in the United States, Construction, Lighting, Roofs, Skylight, Sustainable building, Windows, Medicare, Architecture, Building engineering

We are very excited for this foundational step at Skylight, said Prad Sekar, CEO at Skylight Health.

Key Points: 
  • We are very excited for this foundational step at Skylight, said Prad Sekar, CEO at Skylight Health.
  • We retain the full dollar by contracting directly with CMS on traditional Medicare which means more capital to directly invest in programs that can maximize patient outcomes.
  • ABOUT SKYLIGHT HEALTH GROUP INC.
    Skylight Health Group Inc. (NASDAQ:SLHG;TSXV:SLHG) is a healthcare services and technology company, working to positively impact patient health outcomes.
  • In a VBC model, providers are rewarded for keeping patients healthy and lowering unnecessary health costs instead of volume of services.

iRhythm® Technologies Comments on the Centers for Medicare and Medicaid Services 2022 Proposed Medicare Physician Fee Schedule

Retrieved on: 
Wednesday, July 14, 2021
Healthcare reform in the United States, Federal assistance in the United States, Presidency of Lyndon B. Johnson, Liberalism in the United States, Medicare, Medicaid, Government, Health, United States, Medicare Advantage, Geographic pricing cost index

SAN FRANCISCO, July 14, 2021 (GLOBE NEWSWIRE) -- iRhythm Technologies, Inc. (NASDAQ: IRTC), a leading digital healthcare solutions company focused on the advancement of cardiac care, today provided comment on the recently released Centers for Medicare and Medicaid Services (CMS) Calendar Year 2022 Medicare Physician Fee Schedule Proposed Rule (the Proposed Rule).

Key Points: 
  • SAN FRANCISCO, July 14, 2021 (GLOBE NEWSWIRE) -- iRhythm Technologies, Inc. (NASDAQ: IRTC), a leading digital healthcare solutions company focused on the advancement of cardiac care, today provided comment on the recently released Centers for Medicare and Medicaid Services (CMS) Calendar Year 2022 Medicare Physician Fee Schedule Proposed Rule (the Proposed Rule).
  • The Proposed Rule was released on July 13, 2021, and includes proposed, updated payment policies, payment rates, and other provisions for services furnished under the Medicare Physician Fee Schedule (MPFS) on or after January 1, 2022.
  • In the Proposed Rule, CMS did not propose national rates and proposed to continue with contractor pricing for CPT codes 93241, 93243, 93245 and 93247 for calendar year 2022.
  • We appreciate CMS ongoing focus on developing a national rate for continued access to long-term continuous ECG monitoring services for Medicare beneficiaries.

Glaukos Comments on the Centers for Medicare and Medicaid Services 2022 Proposed Physician Fee Schedule

Retrieved on: 
Wednesday, July 14, 2021
Medical devices, Health, Surgery, Pharmaceutical, Optical, Biotechnology, Healthcare reform in the United States, Federal assistance in the United States, Presidency of Lyndon B. Johnson, American Medical Association, Liberalism in the United States, Medicare, Relative value unit, Current Procedural Terminology, Medicaid, Health, Government, United States

Glaukos Corporation (NYSE: GKOS), an ophthalmic medical technology and pharmaceutical company focused on novel therapies for the treatment of glaucoma, corneal disorders and retinal diseases, today commented on the recently released Centers for Medicare and Medicaid Services (CMS) Calendar Year 2022 Medicare Physician Fee Schedule Proposed Rule.

Key Points: 
  • Glaukos Corporation (NYSE: GKOS), an ophthalmic medical technology and pharmaceutical company focused on novel therapies for the treatment of glaucoma, corneal disorders and retinal diseases, today commented on the recently released Centers for Medicare and Medicaid Services (CMS) Calendar Year 2022 Medicare Physician Fee Schedule Proposed Rule.
  • The Proposed Rule was released on July 13, 2021, and updates payment policies, payment rates and other provisions for services furnished under the Medicare Physician Fee Schedule on or after January 1, 2022.
  • Applying the CMS 2022 Proposed Rules assigned total facility Relative Value Units (RVUs) and associated conversion factor, Glaukos estimates a proposed 2022 physician fee for Category I CPT Code 669X2 of approximately $565.23, representing incremental physician fee payment for the insertion of an aqueous draining device of approximately $34.25 versus the proposed 2022 physician fee of approximately $530.98 for Category I CPT Code 66984 (non-complex cataract surgery alone).
  • Glaukos expects the 2022 Medicare OPPS Proposed Rule to be released by CMS over the coming days to weeks.

Patient care under continued threat in proposed Medicare Physician Fee Schedule

Retrieved on: 
Wednesday, July 14, 2021
Healthcare reform in the United States, Federal assistance in the United States, Presidency of Lyndon B. Johnson, Health, Liberalism in the United States, Medicare, Medicaid, Medicare Advantage

WASHINGTON, July 13, 2021 /PRNewswire/ -- The proposed Medicare Physician Fee Schedule for calendar year 2022 (CY2022) released today by the Centers for Medicare & Medicaid Services (CMS) fails to address pending cuts to surgical care and therefore continues to threaten patient care by reaffirming these previously imposed misguided cuts, argues the Surgical Care Coalition.

Key Points: 
  • WASHINGTON, July 13, 2021 /PRNewswire/ -- The proposed Medicare Physician Fee Schedule for calendar year 2022 (CY2022) released today by the Centers for Medicare & Medicaid Services (CMS) fails to address pending cuts to surgical care and therefore continues to threaten patient care by reaffirming these previously imposed misguided cuts, argues the Surgical Care Coalition.
  • This year's cut is reinstating the cut that Congress prevented last year, which further emphasizes the need for continued congressional intervention to protect patient care.
  • "While CMS is taking notable strides to improve health equity and access to care, today's proposed rule maintains the cuts to surgical care that Congress stopped last year.
  • All patients deserve a health care system that invests in surgical care and does not create uncertainty year after year."

Picwell Adds Plan Comparison Feature to its Benefits Decision Support Solution

Retrieved on: 
Tuesday, July 13, 2021
Health Economics, Deductible, Insurance, Health, Healthcare reform in the United States, Health insurance in the United States, Healthcare in the United States, High-deductible health plan

"Build-a-Plan is an important addition to our benefits decision support solution," said Sam Kina, SVP of Health Economics and Data Science at Picwell.

Key Points: 
  • "Build-a-Plan is an important addition to our benefits decision support solution," said Sam Kina, SVP of Health Economics and Data Science at Picwell.
  • Employees enter the most important details of their partner or spouse's benefits plan and receive a summary that they can directly compare to their employer-sponsored plans.
  • Build-a-Plan clearly displays the premiums, estimated out-of-pocket costs, and deductibles for each plan, and it also estimates the risk protection that each plan provides.
  • "At Picwell, our number one goal has always been to make health care benefits easier to understand," said Matthew Sydney, CEO at Picwell.

CCGroup Launches Cloud/SaaS Subscription Model for Access to National Physician Efficiency Results from CCGroup-CMS Innovator Project

Retrieved on: 
Tuesday, July 13, 2021
Professional services, Health, Technology, Other Health, Software, Consulting, Software, Business models, Software distribution, Computing, Healthcare reform in the United States, As a service, Software as a service, Software industry, Cloud computing, Medicare

CINs/provider groups want access to this physician performance information through the easy-to-use, CCGroup Cloud/SaaS subscription model.

Key Points: 
  • CINs/provider groups want access to this physician performance information through the easy-to-use, CCGroup Cloud/SaaS subscription model.
  • Most CINs/provider groups desire to access physician efficiency and effectiveness data through the CCGroup Cloud/SaaS subscription model, stated John T. Calvin , Vice President of Clinical Systems.
  • Mr. Calvin mentioned, For several decades, CCGroup has remained the market leader in reliably and accurately measuring physician and health system efficiency.
  • The CCGroup-CMS Innovator Project now allows CCGroup access to more than 60 million Medicare beneficiaries claims data over multiple years.