HIT Consultant

JANUARY 18, 2023

– Reimbursable through Medicare and many commercial plans, Ornish Lifestyle Medicine by Sharecare is the first and only ICR program scientifically proven in randomized controlled trials to often reverse the progression of coronary heart disease and many other chronic conditions, without drugs or surgery.

Medicare 98

Medicare Medicare Nurses 98

Hall Render

NOVEMBER 29, 2023

On November 2, 2023, the Centers for Medicare & Medicaid Services (“CMS”) issued the 2024 Medicare Physician Fee Schedule Final Rule (“Final Rule”) for calendar year (“CY”) 2024. Standards for benchmarking and data completeness for the Medicare CQM collection type will mirror the MIPS benchmarking and scoring policies.

Medicare 40

Medicare Medicare Nurses Payment Systems 40

Hall Render

MARCH 21, 2024

The Centers for Medicare & Medicaid Services (“CMS”) recently announced the ACO Primary Care Flex Model (“Flex Model”), a new voluntary model within MSSP for low-revenue ACOs, that begins January 1, 2025.

Medicare 40

Medicare Medicare Medicaid Medicaid 40

HealthIT Answers

SEPTEMBER 25, 2023

By Aisha Pittman MPH & Clif Gaus ScD - NAACOS has been advocating for several changes to the Medicare Shared Savings Program. The post NAACOS Largely Supports Proposed Changes to Medicare’s Largest ACO Program appeared first on Health IT Answers.

Medicare 64

Medicare Medicare 64

Hall Render

MAY 23, 2023

The Centers for Medicare & Medicaid Services (“CMS”) is now accepting applications from ACOs to participate in the Medicare Shared Savings Program (“MSSP” or “Program”) for the agreement period beginning January 1, 2024. The application process is split into two phases.

Medicare 64

Medicare Medicare Medicaid Medicaid 64

Healthcare Law Blog

MAY 5, 2022

Department of Health and Human Services Office of Inspector (“OIG”) released a report that studied prior authorization denials and payment denials by Medicare Advantage Organizations (“MAOs”) (the “Report”). Thirteen percent of denied prior authorization requests met Medicare coverage rules. The OIG Report. additional test results).

Medicare 52

Medicare Medicare Licensing Health Insurance 52

HealthIT Answers

NOVEMBER 28, 2022

By Liz Fowler JD PhD, Purva Rawal PhD, Sarah Fogler PhD, Brian Waldersen MD MPH, Meghan O’Connell MPH, & Jacob Quinton MD MSHS - In 2021, CMS established a goal to have 100 percent of Original Medicare beneficiaries and the vast majority of Medicaid beneficiaries in accountable care relationships by 2030,,, The post The CMS Innovation Center’s (..)

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

HIT Consultant

FEBRUARY 6, 2024

These FQHCs will participate in two key CMS value-based care programs: ACO REACH and MSSP (Medicare Shared Savings Program). The participating ACOs will collectively cover nearly 50,000 Medicare lives, significantly expanding access to value-based care for underserved communities.

Medicare 52

Medicare Medicare 52

Hall Render

APRIL 12, 2024

On April 10, 2024, the Centers for Medicare & Medicaid Services (“CMS”) released the 2025 Inpatient Prospective Payment System (“IPPS”) Proposed Rule (“Proposed Rule”). Hospitals and stakeholders should review whether they are in a county affected by the updated delineations and assess any potential impact on Medicare reimbursements.

Medicare 40

Medicare Medicare Payment Systems Hospitals 40

HIT Consultant

NOVEMBER 16, 2022

People over 85 are the most rapidly expanding demographic and the elderly segment of the American population is expected to double in 2030 from 2010. By 2030, we are projected to have less than 7,300 geriatricians nationwide. The total number of Board Certified Geriatricians in the U.S.

Nurses 52

Nurses Telemedicine Patient Satisfaction Medicare 52

Medisys Compliance

JULY 27, 2022

CMS is planning to gradually reduce this coinsurance until it’s completely free for dates of service on or after January 1, 2030. For dates of service on or after calendar year 2030, Medicare waives the coinsurance. For dates of service calendar years 2027-2029, the reduced coinsurance is 10%.

Medical Billing 52

Medical Billing Medical Billing Outsourcing ACA Medicare 52

Hall Render

NOVEMBER 20, 2023

On November 17, 2023, CMS published its final rule requiring Medicare and Medicaid nursing facilities to provide more detailed ownership and managerial information. The final rule includes new definitions of “private equity company” and “real estate investment trust” for Medicare enrollment purposes. HCA plans to invest $5.3B

Nurses 40

Nurses Medicare Medicare Medicaid 40

Healthcare IT News - Telehealth

DECEMBER 14, 2021

Caravan Health President and CEO Tim Gronniger previously was chief of staff and director of delivery system reform at the Centers for Medicare and Medicaid Services. In 2019 and 2020, its partners earned $300 million in Medicare savings, more than $120 million in shared savings, and quality scores exceeding 97%, the company reported.

Medicare 167

Medicare Medicare COVID-19 Telemedicine 167

MedTrainer

MARCH 8, 2024

These financial incentives are from agencies such as the Centers for Medicare and Medicaid Services (CMS) and the Health Resource & Services Administration (HRSA) , who are working to achieve health equity and improve public health. FQHCs can participate in APMs through Medicare and Medicaid Managed Care Organizations (MCOs).

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

HIT Consultant

FEBRUARY 10, 2022

This focus also supports critical imperatives from the Centers for Medicare & Medicaid Services (CMS) to improve health equity and have everyone in Medicare fee-for-service aligned to an accountable relationship by 2030,” said Kyle Armbrester, CEO of Signify Health. “We

Medicare 52

Medicare Medicare Medicaid Medicaid 52

HIPAA & Health IT

MAY 19, 2023

Ideally, this will manifest in increased interoperability capabilities nationwide—the Centers for Medicare & Medicaid Services has committed to transitioning to value-based arrangements by 2030.

Nursing Homes 52

Nursing Homes Nurses Public Health Medicaid 52

HIPAA & Health IT

MAY 19, 2023

Ideally, this will manifest in increased interoperability capabilities nationwide—the Centers for Medicare & Medicaid Services has committed to transitioning to value-based arrangements by 2030.

Nursing Homes 52

Nursing Homes Nurses Public Health Medicaid 52

Health Populi

JULY 13, 2020

economic outlook for 2020 to 2030 on July 1, 2020. For health care, the data portrayed in the next chart will be concerning: the Medicare and Social Security Trust Funds are expected to hit “zero” (the X-access) by 2025 and just after 2030, respectively. The Congressional Budget Office published an update to the U.S.

COVID-19 106

COVID-19 Medicare Medicare Hospitals 106

HIT Consultant

APRIL 3, 2023

These risk-based care models are designed to encourage proactive care, better population health and reduced spending across the healthcare spectrum.

Medicaid 98

Medicaid Medicaid Medicare Medicare 98

HIT Consultant

MARCH 17, 2024

The Centers for Medicare and Medicaid Services (CMS) has outlined an ambitious objective: to transition all traditional Medicare beneficiaries into a VBC arrangement by 2030, a notable increase from the mere 7% recorded in 2021 by Bain Research.

Medicare 64

Medicare Medicare Medicaid Medicaid 64

Medisys Compliance

APRIL 18, 2022

In October 2021, the Center for Medicare and Medicaid Innovation (CMMI) announced a goal of having every Medicare beneficiary and the majority of Medicaid beneficiaries covered by some type of alternative payment model (APM) by 2030. In order to do so, a clinician must be in a Medicare Advanced APM.

Medical Billing 52

Medical Billing Medical Billing Outsourcing Medicaid Medicaid 52

HIT Consultant

JULY 13, 2022

has been driven by the establishment of the Center for Medicare and Medicaid Innovation (CMMI). Recently, CMMI stated that by 2030 every Medicare beneficiary should be in a value-based relationship – either an ACO or ACO-like model or Medicare Advantage – with a significant emphasis on health equity.

Medicare 98

Medicare Medicare Medicaid Medicaid 98

Jane Sarashon

FEBRUARY 4, 2024

Neither of these explanations satisfies my current view of where I see the industry at this moment, and especially as I work through my forecast to 2030. Retail health-meets-Medicare. This work started in 2023 involving Walmart Health clinics serving Medicare members and looking to partner with UnitedHealth plan members and others.

US Department of Health and Human Services 70

US Department of Health and Human Services Health Insurance Medicare Medicare 70

Hall Render

JULY 7, 2022

The Consolidated Appropriations Act, 2021 (the “Act”) signed into law on December 27, 2020, created a new Medicare provider type called a Rural Emergency Hospital (“REH”). The Act created the new REH Medicare provider type. An REH must provide 24/7 emergency services and certain other outpatient health services.

Hospitals 70

Hospitals Payment Systems Medicare Medicare 70

Hall Render

AUGUST 10, 2023

Background The Medicare Hospital Inpatient Prospective Payment System (“IPPS”) is designed to pay hospitals for services provided to Medicare beneficiaries based on a national standardized amount adjusted for the patient’s condition and related treatment. An “urban area” is defined as an area within an MSA.

Payment Systems 40

Payment Systems Hospitals Medicare Medicare 40

Healthcare IT News - Telehealth

FEBRUARY 19, 2024

By 2030, all Baby Boomers will be over 65 – all as alternative care models emerge. McKinsey estimates $265 billion worth of care services for Medicare patients could shift from traditional facilities to the home by 2025.

Hospitals 141

Hospitals Nurses Medicare Medicare 141

Hall Render

DECEMBER 5, 2022

For more information on this issue or the No Surprises Act generally, please contact: Angela Smith at (317) 977-1448 or asmith@hallrender.com ; Benjamin Fee at (720) 282-2030 or bfee@hallrender.com ; Lisa Lucido at (248) 457-7812 or llucido@hallrender.com ; Matthew Reed at (317) 429-3609 or mreed@hallrender.com ; or.

Medicaid 72

Medicaid Medicaid Medicare Medicare 72

HIT Consultant

APRIL 12, 2022

The entire Baby Boomer generation will be over age 65 by 2030, meaning 1 in 5 Americans will be of retirement age. Through interpersonal communication and technology, DUOS identifies and addresses the individual needs of older adults by leveraging Medicare benefits, trusted partners, and local service providers.

Medicare 52

Medicare Medicare COVID-19 Health Insurance 52

Hall Render

FEBRUARY 20, 2023

More than one year after its effective date, the Centers for Medicare and Medicaid Services (“CMS”) has started investigating consumer complaints alleging provider violations of the No Surprises Act. Assess compliance with the No Surprises Act requirements as part of internal auditing, internal audit, or compliance review practices.

Compliance 40

Compliance Medicaid Medicaid Medicare 40

Healthcare IT Today

JANUARY 23, 2023

Medicare saved $1.6 In addition, Medicare has a goal for 2030 whereby all beneficiaries are to be treated by a VBC provider. billion in 2021 through its Shared Savings Program, which works with accountable care organizations.

Medicare 87

Medicare Medicare 87

HIT Consultant

AUGUST 23, 2022

The Center for Medicare and Medicaid Services (CMS) is leading the charge in value-based-care, with recent updates, including the CY 2023 Medicare Advantage Rate Notice to its CY 2023 Physician Fee Schedule (PFS) Proposed Rule.

Medicare 98

Medicare Medicare Medicaid Medicaid 98

Health Populi

JUNE 3, 2020

McKinsey’s report models outpatient and office visits that can be virtually enabled for patients covered by both commercial and public sector health plans (Medicare and Medicaid). The Deloitte report boldly looks forward to 2030 and 2040, imagining that several forms of healthcare will migrate to virtual formats.

COVID-19 149

COVID-19 Hospitals Medicaid Medicaid 149

Hall Render

APRIL 18, 2023

Background The Medicare Hospital Inpatient Prospective Payment System (“IPPS”) is designed to pay hospitals for services provided to Medicare beneficiaries based on a national standardized amount adjusted for the patient’s condition and related treatment. An “urban area” is defined as an area within an MSA.

Medicare 40

Medicare Medicare Hospitals Payment Systems 40

HIT Consultant

MAY 1, 2023

between 2022 and 2030, with other estimates projecting even faster growth. And while some may have caught wind of RPM reimbursement, we’re coming across other providers who have the misconception that only Medicare reimburses for RPM. One recent report valued the global DTx market at $4.2

Health Outcomes 94

Health Outcomes Medicare Medicare Telemedicine 94

Hall Render

AUGUST 1, 2022

The OPPS Proposed Rule also discusses quality-reporting requirements for REHs, an expedited Medicare enrollment process and REH-specific Stark Law updates. Hospitals may only convert to REHs if they were a CAH or rural hospital with not more than 50 beds participating in Medicare as of December 27, 2020. REH Enrollment Process.

Hospitals 40

Hospitals Payment Systems Medicare Medicare 40

Hall Render

APRIL 20, 2022

The release of the Proposed Rule and the accompanying tables also triggers the start to several deadlines for hospitals, including the unofficial start of the Medicare Geographic Classification Review Board (“MGCRB”) application process. The Medicare program also has an “in between” status called “Lugar status.” Background.

Medicare 40

Medicare Medicare Hospitals Payment Systems 40

Healthcare Law Blog

FEBRUARY 1, 2023

Congress’s expansion of access to telehealth takes steps to ensure continuity of care for Medicare beneficiaries and provides regulators with additional time to determine which flexibilities will become permanent, indicating a success for the telehealth industry as well as a reminder that there is more legislation to come. from 2023 to 2030.

Electronic Medical Records 52

Electronic Medical Records Medicare Medicare Health Outcomes 52