By Lisa Remington|2020-06-30T18:39:29-04:00June 29th, 2020|COVID-19, July-August 2020, Payers, Remington Report|
CMS has provided blanket waivers with a retroactive effective date of March 1, 2020 through the end of the emergency declaration to help providers during COVID-19. We gathered the waivers for discharge planning, in-home care providers, and other post-acute care settings.
By Remington Report|2020-06-30T18:40:05-04:00June 29th, 2020|July-August 2020, Payers, Remington Report, Technology & Data|
Amid COVID-19 pandemic, 91% of Medicare Advantage beneficiaries using telehealth report favorable experiences while a record-setting 99% express satisfaction with their MA plan. 78% are willing to use it again.
By Lisa Remington|2020-06-01T18:46:17-04:00June 1st, 2020|FutureFocus, June 3, 2020, Payers|
In 2020, Medicare Advantage (MA) plans have doubled the number of condition-specific supplemental benefits from approximately 820 to 1,850.
By Lisa Remington|2020-05-27T12:52:04-04:00March 16th, 2020|FutureFocus, March 18, 2020, Payers|
In its March 2020 report to the Congress, MedPAC makes payment policy recommendations for provider sectors in fee-for-service (FFS).
By Lisa Remington|2020-05-27T12:51:59-04:00March 16th, 2020|FutureFocus, Hospice & Palliative Care, March 18, 2020, Payers|
Aggressive moves by payers teaming up with big players such as CVS are advancing their healthcare programs into the home. How does this impact healthcare organizations?
By Lisa Remington|2020-05-27T12:51:55-04:00March 11th, 2020|FutureFocus, March 12, 2020, Payers, Post-Acute|
Aggressive moves by payers teaming up with big players such as CVS are advancing their healthcare programs into the home. How does this impact healthcare organizations?
By Lisa Remington|2020-05-27T12:51:50-04:00March 11th, 2020|ACOs & Health Systems, FutureFocus, March 12, 2020, Payers, Post-Acute|
Landmark estimates about 20 percent of chronically ill patients currently experience a gap in the care they are receiving, which can be addressed through medical care, support and education provided in the home.
By Lisa Remington|2020-05-27T12:51:45-04:00March 9th, 2020|FutureFocus, March 11, 2020, Payers|
The Center for Medicare and Medicaid Innovation’s Emergency Triage, Treat, and Transport (ET3) Model is designed to test expanded care destination alternatives to the ED for Medicare beneficiaries who call 911.
By Elizabeth Hogue|2020-05-27T12:51:32-04:00March 2nd, 2020|FutureFocus, March 4, 2020, Payers, Post-Acute|
How can providers offer support for caregivers? A key way for providers to assist may be to collaborate with charitable organizations in the community.
By Lisa Remington|2020-05-27T12:41:37-04:00February 18th, 2020|February 19, 2020, FutureFocus, Payers|
Medicare Advantage and Part D programs for contract years 2021 and 2022Â has provisions changing care management requirements for special needs plans.
By Lisa Remington|2020-05-27T12:41:56-04:00February 11th, 2020|February 12, 2020, FutureFocus, Payers|
In a proposed rule issued on February 5, CMS announced that beneficiaries with ESRD will be able to enroll in Medicare Advantage Plans starting in 2021.
By Lisa Remington|2020-05-27T12:42:01-04:00February 11th, 2020|February 12, 2020, FutureFocus, Payers, Technology & Data|
CMS issued a proposed rule and the Advance Notice Part II to further strengthen and modernize the Medicare Advantage and Part D prescription drug programs.
By Lisa Remington|2020-05-27T12:43:12-04:00December 2nd, 2019|December 4, 2019, FutureFocus, Payers|
An integrated program of services can contribute to reducing the cost of care and services to Medicare beneficiaries residing in seniors housing.
By Lisa Remington|2020-05-27T12:43:35-04:00November 20th, 2019|FutureFocus, November 20, 2019, Payers, Post-Acute|
The tides are shifting the expectations of home care. Pressure from reimbursement, shifting payment models, and value-based care are driving the change.
By Lisa Remington|2020-05-27T12:45:10-04:00October 23rd, 2019|FutureFocus, October 23, 2019, Payers, Post-Acute|
Starting November 1, UnitedHealthcare will not pay for unplanned surgeries in an outpatient setting unless it determines the site is medically necessary.
By Lisa Remington|2020-05-27T12:45:57-04:00October 9th, 2019|FutureFocus, October 9, 2019, Payers, Technology & Data|
Private Medicare plans will soon include expanded plan options for seniors, more telehealth, and innovative plan designs and payment models.
By Lisa Remington|2020-05-27T12:46:17-04:00October 2nd, 2019|FutureFocus, October 2, 2019, Payers|
Medicare Advantage (MA) Plans are adding two new dementia codes in their risk adjustment payment system and expanding flexibility in the MA benefit design.
By Lisa Remington|2020-06-08T14:28:45-04:00September 25th, 2019|FutureFocus, Payers, Post-Acute, September 25, 2019|
A unified value-based incentive program for SNFs, home health services, inpatient rehabilitation facilities, and long-term care hospitals is recommended.
By Lisa Remington|2020-06-08T14:29:35-04:00September 25th, 2019|FutureFocus, Payers, September 25, 2019|
A GAO report explored the efforts to manage high-expenditure beneficiaries, which are 5% of all Medicaid beneficiaries but nearly half of all expenditures.
By Lisa Remington|2020-06-01T20:22:29-04:00September 6th, 2019|MarketWatch, Partnership Development, Payers, Post-Acute|
Payers and providers are redefining and rethinking how new models of care can move the needle toward value-based care.
By Lisa Remington|2020-06-01T20:46:56-04:00September 6th, 2019|Case Studies, Payers, Post-Acute|
Kaiser Permanente Colorado and VNA-Denver jointly offer intense, consistent education to elderly heart failure patients discharged from the hospital.
By Lisa Remington|2020-06-01T20:47:02-04:00September 6th, 2019|Case Studies, Payers, Physicians|
Fragmentation of the care delivery system is widely recognized as a cause of missed opportunities to treat both acute and chronic conditions.
By Lisa Remington|2020-06-01T20:28:50-04:00September 6th, 2019|MarketWatch, Payers, Payment & Delivery Models|
People who are continuously enrolled in Medicare Advantage are less likely to die in a hospital than those continuously enrolled in Medicare fee-for-service.
By Lisa Remington|2020-06-01T20:47:23-04:00September 5th, 2019|Case Studies, Payers, Post-Acute|
A recent filing by Humana indicates the insurer is instituting a new bonus plan that is not just tied to financial performance, but also to health outcomes.
By Lisa Remington|2020-06-01T20:29:37-04:00September 5th, 2019|MarketWatch, Payers, Payment & Delivery Models, Post-Acute|
CMS recently proposed a new payment model that would bundle payment to acute care hospitals for heart attack and cardiac bypass surgery services.
By Lisa Remington|2020-06-01T20:30:32-04:00September 5th, 2019|Hospice & Palliative Care, MarketWatch, Payers, Payment & Delivery Models|
Payers and Alternative Payment Models (APMs) are turning to palliative care programs as a way to offer value-based end-of-life care.
By Lisa Remington|2020-06-01T20:31:02-04:00August 26th, 2019|MarketWatch, Partnership Development, Payers, Post-Acute|
Medicaid’s reform will lead to greater care coordination, a focus on reducing costs and more possibilities of risk and preferred provider networks.
By Lisa Remington|2020-06-01T20:48:23-04:00August 26th, 2019|Case Studies, Payers, Post-Acute|
Aetna’s Compassionate Care Program is designed to improve the quality of patient care for individuals with life-threatening illnesses.
By Lisa Remington|2020-06-01T20:38:32-04:00August 26th, 2019|MarketWatch, Payers, Payment & Delivery Models, Post-Acute|
Early evidence suggests that, under episode-based incentives, clinicians and organizations can improve the value of care for certain episodes.
By Lisa Remington|2020-06-01T20:39:21-04:00August 19th, 2019|MarketWatch, Partnership Development, Payers, Readmissions|
Greater use of Medicare Advantage over traditional fee-for-service Medicare has been associated with fewer overall hospitalizations.
By Lisa Remington|2020-06-01T20:40:48-04:00July 19th, 2019|MarketWatch, Payers, Performance Improvement, Readmissions, Technology & Data|
Telehealth policy develops much more slowly than the rapidly advancing technology, but incremental changes are taking place.
By Lisa Remington|2020-06-01T20:41:25-04:00July 19th, 2019|MarketWatch, Partnership Development, Payers, Readmissions|
In 2014, 14% of inpatient stays were readmitted within 30 days. More than one-third of these readmissions occurred within seven days.
By Lisa Remington|2020-05-27T12:47:19-04:00July 10th, 2019|FutureFocus, Payers, Physicians|
This issue of FutureFocus highlights the innovation of an in-home, physician-led model working collaboratively with a payer to manage complex care.
We monitor complex key trends and forces of change to road map the future to de-risk decision-making and drive opportunity innovation. Our strategy-based solutions, driven by accurate predictability, navigate organizations through disruption. Forward-thinking solutions identify new growth and revenue opportunities, define strategic alignment for collaborative value-based partnerships, and pursue greater opportunities based on our cross-sector knowledge. We help our clients think broadly about the future of the healthcare industry, identify shared strategic insights, advance forward-thinking solutions, and develop go-to market capabilities.
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