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Managed Healthcare Executive: Bundled Payment Program Cost CMS $279 Million: JAMA Study

By In the News

From Managed Healthcare Executive: One of CMS’s signature value-based care programs wound up costing rather saving CMS money, according to results of a study published this week in JAMA. Although the results can be interpreted in different ways, the study may put a dent in the reputation of value-based care and its promise as a way to rein in U.S. healthcare spending while also keeping the quality of care high. The study by Sukruth A. Shashikumar of the Washington University School of Medicine in St. Louis and his colleagues showed that Bundled Payments for Care Improvement Advanced (BPCI-A) was associated with a $279 million increase…

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Bloomberg Law: Growth of Private Medicare Plans Clouded by Payment Questions

By In the News

From Bloomberg Law: A fast-approaching enrollment tipping point for Medicare managed care plans is increasing the urgency for Congress and the HHS to resolve payment issues that threaten the viability and cost-effectiveness of the popular coverage option. Medicare Advantage plans were paid $350 billion in taxpayer funding in 2021, and now cover nearly 46%, or more than 29.7 million, of Medicare’s 64.6 million beneficiaries. MA plan enrollment is expected to hit 31.8 million next year. In the near future, a majority of Medicare beneficiaries are expected to receive their benefits through MA plans, rather than through traditional fee-for-service Medicare. That coverage milestone…

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Philadelphia Inquirer: Home Visiting Programs Allow Nurses To ‘Meet Families Where They’re At.’ Advocates Want Congress To Extend Its Funding

By In the News

From The Philadelphia Inquirer: NaTosha Robinson has stage four lymphoma and after losing her left lung in 2020 often struggles to breathe. Her 5-year-old daughter, Sierra, struggled with delayed speech development. Robinson wanted to prepare her for school but didn’t know how to address concerns like Sierra’s difficulty holding a crayon, while also coping with her own health challenges. “It’s a lot being a single parent and doing it on your own,” she said. Things changed in 2021, when Jackie Nguyen entered their lives through a federal program that provides at-home support to pregnant people and families with young children who…

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The ASCO Post: Can a Navigation Program Lower Care Costs for Patients With Cancer?

By In the News

From The ASCO Post: A cancer navigation program can reduce overall costs when deployed in collaboration with a statewide Medicare Advantage health plan across a wide range of practice types, according to findings to be presented by Worland et al at the upcoming 2022 ASCO Quality Care Symposium (Abstract 4). A reduction of $429 per health plan member per month was seen when patient navigation services were made available compared to no navigation services. “New and more effective therapies for cancer are constantly being introduced. Despite many of these advances, care coordination can often be fragmented, education about the best care…

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