iLoveBenefits: Industry News Blog

Patrick Conway on lower hospital ED use

Patrick Conway will be one of the Novembe 2015 Cracking the Code on Health Care speakers in Rochester, NY

CMS official links lower hospital, ED use to support for primary care
A 2% decrease in hospital admissions and emergency department visits can be linked to increased CMS support for primary care, the agency’s chief medical officer, Patrick Conway, told the National Quality Forum’s annual conference. He highlighted several population health and coordinated care projects, initiated by hospitals and physician practices, that have reduced costs and improved quality of care. HealthLeaders Media

Reimbursement is beginning to change in important ways

Effective January 1st, the Centers for Medicare and Medicaid Services (CMS) began reimbursing providers who actively manage care delivery for Medicare patients who have two or more chronic conditions. According to a recent health care provider survey, 76% of respondents planned to organize and structure to meet Medicare’s chronic care management program requirements within the next six months.



Calling all stakeholders – working together to reduce readmissions

Readmissions become bigger issue for primary care physicians CMS penalties on hospitals with high readmission rates have put pressure on primary care physicians to help keep patients from needing additional inpatient stays. Physicians are using post-discharge care management programs and forming accountable care organizations that focus on performance-based care. Medscape (free registration)

Patrick Conway has been promoted

CMS announced in an internal memorandum that Patrick Conway will become acting principal deputy administrator of the Centers for Medicare & Medicaid Services. Conway, who is currently deputy administrator for innovation and quality and CMS chief medical officer, will assume the position following the departure of Marilyn Tavenner as CMS administrator later in February, Andy Slavitt, the current CMS principal deputy administrator, will become acting administrator at the end of this week. “Patrick will play a critical role in driving and coordinating our policy initiatives across Medicare, Medicaid, and the Children’s Health Insurance Program,” and he will continue to lead initiatives on delivery system reform, the memorandum said.

March 3, 2015 | Categories: healthcare | Tags: , , | Comments (0)

Bending the health care cost curve . . . not so much

CMS Private Health Insurance Premium Growth Projections

According to recent projections by Centers for Medicare & Medicaid Services:

  • 2012-2013 spending for total private health insurance premiums projected to have grown by 3.3%.
  • 2013 premiums expected to grow at 3.0% due to 6.0% growth in net cost of private health insurance.
  • 2014 private health insurance premium growth is projected to reach 6.6%.
  • 2015 private health insurance spending growth expected to remain elevated at 6.9%.
  • 2016-2023 average private health insurance spending growth expected to sustain at 5.4% per year.

Source: NHE Projections 2013-2023 – Forecast Summary CMS, September 2014

September 9, 2014 | Categories: Benefits,Cost,healthcare,insurance | Tags: , , , , | Comments (0)

Coming Soon: Dollars to Docs

The federal government will begin releasing information how much it pays individual physicians in Medicare starting next week, Centers for Medicare and Medicaid Services officials said Wednesday.

Is health care cost containment possible

Health care spending may be poised to accelerate, report finds

Data from a CMS report showed U.S. spending on health care grew by 3.9%
in 2011, marking the third year in a row of relatively small increases in
spending. However, the report suggests spending growth may pick up in the
coming years as the economy rebounds. The report appears in the journal Health
Affairs. Reuters (1/7)

January 8, 2013 | Categories: Benefits,Cost,healthcare | Tags: , , , , | Comments (0)

Stage 2 meaningful use requirements released

The proposed Stage 2 meaningful-use requirements raise the bar for hospitals and eligible professionals on the use of computerized physician order entry, electronic prescribing and electronic recording of several patient-health measures, according to CMS officials.
Under the proposed Stage 2 standards, hospitals as well as eligible professionals—the latter category includes physicians not employed by hospitals—would have to use CPOE for more than 60% of medication, laboratory and radiology orders, double the share required under the Stage 1 standards.

Parting thoughts: Berwick shares views on media coverage of health care and reform

Health reporters, both veterans and novices, know Don Berwick, M.D., M.P.P., as one of the most thoughtful and powerful forces in U.S. health care today. He has worked with reporters as part of his jobs at the Institute for Healthcare Improvement and, most recently, at the Centers for Medicare and Medicaid Services. He has served as a professor at Harvard Medical School and at Harvard School of Public Health and worked as a pediatrician in Boston.

Berwick left CMS in December and agreed to share his thoughts with AHCJ President Charles Ornstein about media coverage of CMS, health reform and his tenure.

Q. What are your overall impressions about the way the media covered CMS during your tenure there?

A. I generally had a favorable impression. Many of the people I dealt with in the press were very, very knowledgeable and asked me tough and deep questions. I’d say the majority of my encounters, especially with the DC-based media, felt like dealing with experts.

I found two things that, as I reflected, may imply suggestions for improvement. One is the amount of in-depth coverage. As we were dealing with very, very complex issues, which is standard for CMS, and the Affordable Care Act, I found the majority of the reports, as opposed to the interviews, shallow. There weren’t a sufficient number of longer in-depth analyses of what really was going on and what were the pros and cons of the choices the government, and our nation, are making.

My job was to think through very, very difficult issues. I would think sound media would be addressing the issues with the same discipline that we were using internally. … That requires longer stories and more print than most reporters are probably able to command.

The other side of it is that there is still more gotcha in the media than I think is productive. This tendency of journalists, not all by any means but some, to kind of wait for the two-word phrase that can become the headline, I think, is unfortunate. I understand why in business terms or commercial terms that might be necessary but it does not support public exploration. What it does induce is extreme caution and pre-packaged answers. One is always thinking about how not to offer the journalist a three-word phrase that will become the misleading headline of what’s happening. I think I learned to do that but I would hope, at least naively, that there could be a different social contract about what the media is doing.

Read more here:

This is a fascinating and beneath the veneer that we often see in politicians – Don isn’t a politician – rather a deep thinking and incredibly knowledgeable health care leader. I strongly urge that you read this article.

CMS makes online EHR resource available for providers

The CMS has issued a “comprehensive tool” to guide qualifying providers through each step of the Medicare EHR incentive program. The online interactive resource offers information on issues such as program fundamentals, enrollment and eligibility, as well as the stage 1 meaningful use requirements. Modern Physician (free registration) (12/1)

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