iLoveBenefits: Industry News Blog

Medicare hospice palliative and curative care will be allowed for the first time

CMS announced the new Medicare Care Choices Model which will allow beneficiaries who qualify for the Medicare hospice benefit to receive palliative and curative care at the same time, which isn’t permitted under current Medicare payment rules. Under the five-year demonstration, CMS said participating hospices will provide services that are currently available under the Medicare hospice benefit for home care and respite levels of care, but cannot be billed separately under Parts A, B and D. For each beneficiary, CMS will pay a $200 to $400 monthly fee. Services will start next year for the first round of hospices and then in January 2018 for the rest. 

July 27, 2015 | Categories: Benefits,healthcare,Medicare | Tags: , , | Comments (0)

Independent Payment Advisory Board will be triggered for the first time

July 2015, implementation of the Independent Payment Advisory Board will be triggered for the first time in just two years, based on projections included in the annual report issued by Medicare’s trustees. That controversial ACA panel would be required to recommend cuts if Medicare exceeds spending growth thresholds. Conservatives have pilloried the board as potentially a means to ration care for seniors, and the House voted earlier this year to repeal it.

How Does Medicare Spend its Money

Latest Medicare Payment Composition Data

Here are some key findings from the new 2013 Medicare spending data released by CMS:

  • Over 950,000 health care providers collectively received about $89 billion in Medicare payments in 2013.
  • This includes $17 billion for drugs administered and $72 billion for medical services.
  • Spending on psychiatry rose 9.3%, to $853 million.
  • $32 million was spent on sports medicine, for an increase of 56%.
  • Sleep medicine spending increased, as 100 new practitioners in the specialty received $7.2 million.
  • Spending on general practice decreased by 7.6% to $380 million.

Source: Centers for Medicare and Medicaid Services, June 2, 2015

June 9, 2015 | Categories: Benefits,Cost,insurance,Medicare | Tags: , , , | Comments (0)

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

Accenture Survey: Majority of Seniors Want to Access Healthcare From Home

An Accenture survey regarding senior attitudes toward digital healthcare tools found that:

  • 67% of seniors want to access healthcare service from home.
  • 66% of seniors do not think available technology is sufficient for them to access healthcare from home.
  • Currently 25% of seniors use electronic health records portals regularly to manage their health.
  • Of those that currently use these portals, 57% use them to access lab results.
  • More than 60% of seniors are willing to wear a health tracking device to monitor vital signs.
  • Over 66% of seniors prefer to use self-care technology rather than managing health independently.

Source: Accenture, March 2, 2015

5% of Seniors Admitted to Hospital within 1 Week After ER Release

Study: Close to 5% of older ED patients are hospitalized within a week A study in the Journal of the American Geriatrics Society revealed close to 5% of seniors who visit the emergency department are hospitalized within a week of being released. Old age was among the predictors of hospitalization, and end-stage renal disease, chronic kidney disease and congestive heart failure were the conditions tied to the highest likelihood of admission. News (1/23)

Everyone’s destiny is health care . . . we need to improve this . . . for ourselves

Survey: 68% of older U.S. adults have multiple chronic conditions A survey from The Commonwealth Fund of 15,617 older adults in the U.S. and 10 other countries showed 68% of Americans had two or more chronic conditions and 53% were taking four or more medications, which were higher rates than reported in some other countries. Other countries had better rates of same-day care than the U.S., but Americans had faster access to specialist care. The findings were published in Health Affairs. Health Affairs Blog

How much will you need in retirement to cover health care expenses

According to projections in a recent report, in 2014, a man would need $64,000 in savings and a woman would need $83,000 if each had a goal of having a 50% chance of having enough money saved to cover health care expenses in retirement. Source: “Needed Savings for Health Care in Retirement Continue to Fall,” Employee Benefit Research Institute (EBRI) Press Release, October 28, 2014,

The move to outpatient care . . . not so fast

According to a recent analysis of Medicare data from between 2008 and 2011, researchers found that one extra day in the hospital:

  • Reduced mortality risk for patients treated for pneumonia by 22%
  • Reduced mortality risk for heart attack patients by 7%
  • Reduced readmissions for severe heart failure patients by 7%
  • Saved five-to-six times more lives compared with outpatient care

Source: “ONE EXTRA DAY IN THE HOSPITAL CUTS READMISSION RATES AND REDUCES PATIENT DEATHS,” Columbia Business School Press Release, October 28, 2014,  

What are you doing to prepare for retiree health care?

According to a recent study by Ameriprise Financial:

  • 86% of baby boomers express concern about the affordability of health care in retirement.
  • 19% surveyed say they have taken one or more steps to prepare.
  • 26% have reviewed their options but have taken no action.
  • 40% have thought about it but haven’t looked into it in detail.
  • 15% of respondents haven’t begun to consider how they will cover health care costs in retirement.

Note: Data from more than 1,000 employed baby boomers ages 50-64 who are preparing for retirement with at least $100,000 in investable assets, asked these individuals about their attitudes toward health, health care costs and the impact each may have in retirement.

Source: Business Wire

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