Payers

Medicare Advantage Plans, Payer, and Provider Partnerships

The Vulnerabilities of COVID-19 Expand Insurers Capabilities In the Home

PREMIUM CONTENT Insurers' strategies to provide greater services in the home are moving rapidly. Changing models have insurers partnering-up with primary care physicians, telehealth, and pharmacies to deliver care in the home. We provide insights to insurers' reactions post COVID-19 and beyond.

The Vulnerabilities of COVID-19 Expand Insurers Capabilities In the Home2020-09-06T13:50:46-04:00

Stronger Strategic Partnerships: Data Exchange is a Driving Factor

PREMIUM CONTENT Payers are interested in talking about the data. In particular, they are interested in understanding how home care providers are able to reduce their penalties and increase their rewards in a value-based payment system. Learn how one organization is advancing conversations.

Stronger Strategic Partnerships: Data Exchange is a Driving Factor2020-09-06T13:50:57-04:00

Strategy Insight: How To Align Financial and Clinical Incentives with Payers and the Most Costliest Medical Conditions

In this article, we take a look at data reflecting the costliest medical conditions by payers. This becomes an important strategy as payers begin to move more value-based care contracting into the home care space and look to treating higher acuity patients in the home.

Strategy Insight: How To Align Financial and Clinical Incentives with Payers and the Most Costliest Medical Conditions2020-09-23T15:41:24-04:00

COVID-19 Medicare Emergency Waivers For Discharge Planning And Home Care Providers

PREMIUM CONTENT 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.

COVID-19 Medicare Emergency Waivers For Discharge Planning And Home Care Providers2020-09-06T13:51:41-04:00

Payers: 2020 Supplemental Benefits for Chronic Conditions Doubled

In 2020, Medicare Advantage (MA) plans have doubled the number of condition-specific supplemental benefits from approximately 820 to 1,850. However, the new Special Supplemental Benefits for the Chronically Ill (SBBCI) for 2020 didn’t fare as well.

Payers: 2020 Supplemental Benefits for Chronic Conditions Doubled2020-09-23T15:43:00-04:00

Payment Recommendations for 2021

In its March 2020 report to the Congress, MedPAC makes payment policy recommendations for provider sectors in fee-for-service (FFS).

Payment Recommendations for 20212020-05-27T12:52:04-04:00

Medicare’s Option to Avoid the Emergency Department

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.

Medicare’s Option to Avoid the Emergency Department2020-05-27T12:51:45-04:00

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