FutureFocus February 7, 2018 Post-Acute Cost By Care Settings For The Dual Eligible: Eight Things To Know

Lisa Remington

In this week’s FutureFocus, we explore post-acute costs by care settings for the dual eligible. Important data helps to understand why costs are higher within the entire post-acute discharge period and in particular areas of post-acute. This important data ties back to Medicare Spending per Beneficiary. In another article, we discuss medication non-adherence solutions for Medicare patients. Our Washington Report addresses how CMS is launching a low volume appeals initiative.

Lisa Remington, President, Remington Health Strategy Group

A study in Health Affairs found that after adjustment for comorbidities, dually enrolled beneficiaries had 4.3 percent higher spending, which was primarily driven by higher costs in the post-acute setting associated with use of institutional post-acute care.

Non-adherence is a major concern in the management of chronic conditions such as hypertension, cardiovascular disease, and diabetes where patients may discontinue or interrupt their medication for a number of reasons.

The Centers for Medicare & Medicaid Services has begun accepting Expressions of Interest (EOIs) for a limited settlement agreement option for Medicare Fee-For-Service providers, physicians, and suppliers (appellants) with fewer than 500 appeals pending at the Office of Medicare Hearing and Appeals (OMHA) and the Medicare Appeals Council (Council) at the Departmental Appeals Board.