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Tag: Insurance: Medicare

The Centers for Medicare & Medicaid Services has launched an initiative to examine which provider regulations should be discarded or revamped amid concerns that the regulations are reducing the amount of time that physicians spend with patients

CMS Launches Initiative to Examine Impact of Regulations

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Officials set to travel country gathering information on impact of their regulations on physicians
Transition from a condition-specific to a hospital-wide readmission measure would result in a modest increase in the number of hospitals eligible for readmission penalties and would substantially increase penalties for safety-net hospitals

More Penalties With Hospital-Wide Readmission Measure

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Increase in number of hospitals eligible for penalties, in penalty disparity for safety-net, other hospitals
Much of the total potentially preventable spending for Medicare beneficiaries is concentrated among frail elderly individuals

Potentially Preventable Spending Concentrated in Frail Elderly

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Variation in preventable spending across Medicare subpopulations; 43.9 percent of total in frail elderly
In an effort to restrict daily allowable prescribed dosing of prescription opioids

Medicare Coverage Restrictions for Opioids Rose From ’06 to ’15

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Formularies increasingly using quantity limits and prior authorization to restrict daily allowable dosing
The 2016 Physician Quality Reporting System and the 2016 annual Quality and Resource Use reports have been released for individuals and group practices

2016 Physician Quality Reporting System Reports Available

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Physicians should review reports to know whether they are subject to 2018 PQRS payment adjustment
Medicare paid at least $1.5 billion over a decade to replace seven types of defective heart devices that apparently failed for thousands of patients

Medicare Paid $1.5 Billion to Replace Faulty Heart Devices

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Reasons for replacement included recalls, premature failures, medically necessary upgrades, infections
Prescribing generic drugs for seniors' eye problems could save the U.S. government hundreds of millions of dollars a year

Switching to Generic Eye Meds Could Save Medicare Millions

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Medicare is billed more than $1 billion annually for glaucoma treatments alone, researchers say
For community-dwelling older adults

Preadmission Functional Impairment Ups Medicare Costs

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Increase in mean Medicare costs after discharge linked to severity of preadmission impairment
Medicare Advantage is associated with more racial disparity than traditional Medicare for hospital readmissions

More Racial Disparity With Medicare Advantage

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More racial disparity versus traditional Medicare for hospital readmissions for six major surgeries
From 1991 to 2014 there was minimal change in health spending by state

1991-2014 Saw Minimal Change in Health Spending Per State

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Recession and recovery, implementation of health reform impacted health care coverage