Home » Archives by category » News » Medicare News (Page 3)

Part D Payment for Drugs for Beneficiaries Enrolled in Medicare Hospice

CMS: July 18, 2014 On June 25, 2014, CMS met with a number of stakeholder groups to discuss the implementation of the final 2014 guidance on Part D payment for beneficiaries enrolled in the Medicare hospice benefit (memorandum dated March 10, 2014). Beneficiary advocates, hospice providers, Part D sponsors/pharmacy benefit managers, and pharmacies discussed their […]

The Early Effects of Medicare’s Mandatory Hospital Pay-for-Performance Program

Wiley: 15 JUL 2014 Objective To evaluate the impact of hospital value-based purchasing (HVBP) on clinical quality and patient experience during its initial implementation period (July 2011–March 2012). Data Sources Hospital-level clinical quality and patient experience data from Hospital Compare from up to 5 years before and three quarters after HVBP was initiated. Study Design Acute […]

The Medicare Physician-Data Release — Context and Rationale

The Medicare Physician-Data Release — Context and Rationale

NEJM: July 10, 2014 On April 9, the Centers for Medicare and Medicaid Services (CMS) released detailed information on utilization by more than 880,000 physicians and other health care providers who care for Medicare beneficiaries. This data release was unprecedented in its size and scope: it included nearly 10 million records accounting for more than […]

Caution Advised: Medicare’s Physician-Payment Data Release

Caution Advised: Medicare’s Physician-Payment Data Release

NEJM: July 10, 2014 On April 9, 2014, Health and Human Services Secretary Kathleen Sebelius announced the release of privacy-protected data concerning services provided to beneficiaries enrolled in the fee-for-service Medicare program in 2012; the services were provided by individual physicians and other health care professionals.1,2 The release occurred 10 months after federal district court judge Marcia […]

Unplanned admissions and readmissions in older people: a review of recent evidence on identifying and managing high-risk individuals

Unplanned admissions and readmissions in older people: a review of recent evidence on identifying and managing high-risk individuals

Cambridge University Press: 7/10/14 Rising unplanned hospital admissions are a problem in ageing populations worldwide. These admissions are associated with poor outcomes for older people, contribute to rising health care costs and impede the provision of planned care. Policy and practice in recent years has focused on identification of those at risk of unplanned admission and […]

Questionable Billing for Medicare Part B Clinical Laboratory Services

HHS – Office of Evaluation and Inspections: 7/8/14 WHY WE DID THIS STUDY Medicare is the largest payer of clinical laboratory (lab) services in the nation. From 2005 to 2010, Part B Medicare enrollment increased by 10 percent, while spending for lab services increased by 29 percent. In 2010, Medicare payments for all Part B lab […]

No Evidence Found That Hospitals Are Using New Electronic Health Records To Increase Medicare Reimbursements

Health Affairs: July 2014 The recent uptick in hospital adoption of electronic health records (EHRs) has been accompanied by growing concerns among some policy makers that hospitals may use these systems to select billing codes that reflect more intensive care or a sicker patient population in order to generate more revenue through higher reimbursements. Such “upcoding” […]

The Mystery of the Missing $1,000 Per Person: Can Medicare’s Spending Slowdown Continue?

The Mystery of the Missing $1,000 Per Person: Can Medicare’s Spending Slowdown Continue?

KFF: Jul 08, 2014 As Medicare and budget wonks eagerly await the 2014 edition of the Medicare Trustees’ report, the big story in the Medicare world these days is the slowdown in program spending.  Based on our comparison of CBO’s August 2010and April 2014 baselines, Medicare spending this year will be about $1,000 lower per person than was […]

Medicare Health and Prescription Drug Plans

Medicare Health and Prescription Drug Plans

KFF: 7/8/14 This data collection covers private plans participating in the Medicare Advantage program and the Medicare prescription drug program.   Medicare Advantage: Enrollment Medicare Advantage: Total Enrollment Medicare Advantage Enrollees as a Percent of Total Medicare Population Medicare Advantage: Total Enrollment, by Plan Type Medicare Advantage Enrollees as a Percent of Total Medicare Population, by Plan Type Medicare […]