Category: Blog

three-key-targets-for-payers-during-medicare-open-enrollment

Three Key Targets for Payers During Medicare Open Enrollment

Affordability, simplicity, and accessibility remain the three targets that payers aim to hit during Medicare open enrollment season, according to Christopher Ciano, president of Aetna Medicare. Listen to the full podcast to hear more details. And don’t forget to subscribe on iTunes, Spotify, or Google Podcasts. The push for greater affordability is perhaps most evident […]
Learn More
cms-releases-physician-fee-schedule-final-rule

CMS Releases Physician Fee Schedule Final Rule

  CMS says it the goal is to support health equity while focusing on high-quality person-centered care. Increased leverage of telehealth for behavioral care, diabetes prevention and mitigation, and enhanced payment for vaccine administration were three out of many priorities cited by federal officials who announced the release of the Centers for Medicare & Medicaid […]
Learn More
the-impact-of-coding-on-maternal-outcomes-part-iii

The Impact of Coding on Maternal Outcomes: Part III

Severe maternal morbidity often intersects with cesarean deliveries. Reducing the number of cesarean deliveries can lower the maternal mortality rate, and one of the drivers of cesarean rates is thought to be induction of labor (IOL). In 2014, the American College of Obstetricians and Gynecologists (ACOG) adopted definitions for labor, labor induction, and augmentation of […]
Learn More
cms-releases-final-rule-for-cy-2022-medicare-physician-fee-schedule

CMS Releases Final Rule for CY 2022 Medicare Physician Fee Schedule

CMS has finalized the calendar year (CY) 2022 Medicare Physician Fee Schedule to promote greater telehealth utilization, boost reimbursement rates for vaccine administration, and improve health equity, among other initiatives, the federal agency said. The final rule will implement “a series of standard technical proposals” as part of CY 2022 rate-setting, CMS said. The conversion […]
Learn More
the-role-of-provider-sponsored-health-plans-in-value-based-care

The Role of Provider-Sponsored Health Plans in Value-Based Care

Provider-sponsored health plans can be naturally aligned with value-based care goals while also being attuned to providers’ needs. Providence Health Assurance’s Medicare Advantage provider-sponsored health plan received a five-star rating through the CMS Medicare Advantage Star Ratings system for the 2022 Medicare open enrollment season. The health plan, which serves Oregon and Washington State, is […]
Learn More
cms-updates-end-stage-renal-disease-apm-pps-to-address-health-equity

CMS Updates End-Stage Renal Disease APM, PPS to Address Health Equity

The End-Stage Renal Disease (ESRD) Treatment Choices Model is the first to undergo changes to directly address health equity—a new goal for CMS-run alternative payment models. The ESRD Treatment Choices (ETC) Model is a mandatory alternative payment model (APM) that encourages greater utilization of home dialysis and kidney transplants for Medicare beneficiaries with the chronic […]
Learn More
medicare-drops-end-stage-renal-disease-payment-rule-aims-to-close-health-equity-gaps

Medicare drops end-stage renal disease payment rule that aims to close health equity gaps

The Biden administration dropped a final rule Friday that will reward providers that improve rates of home dialysis and kidney transplants among low-income Medicare and dual-eligible beneficiaries. The goal of the changes is to encourage dialysis providers to decrease disparities in home dialysis and transplant rates, part of a larger effort by the Biden administration. […]
Learn More
cpt-code-set-adds-code-for-jj-covid-19-vaccine-booster

CPT Code Set Adds Code for J&J COVID-19 Vaccine Booster

  AMA updated the CPT code set to accommodate the new mix-and-match COVID-19 vaccine booster strategy endorsed by the federal government. The update comes on the heels of a decision from the Federal Drug Administration (FDA) to authorize booster doses of Janssen’s COVID-19 vaccine. The federal agency has recommended a booster dose of the vaccine […]
Learn More
x