MA for Tomorrow: Moving Beyond the Status Quo to Advance Concrete Policy Changes for the Future of Medicare Advantage
BY CECI CONNOLLY AND MICHAEL BAGEL
Medicare Advantage (MA) has passed the tipping point, delivering coverage and care to more than half of the senior population in the US. The Congressional Budget Office projects more than 60 percent of people 65 years and older will be in the program by 2030. As enrollment soars and interest in value-based health care grows, it is imperative policymakers modernize the program that is expected to cost $7.5 trillion over the next decade.
Rather than taking the standard Washington posture of declaring victory or defending the status quo, our provider-aligned, nonprofit member pla...
Source: The Health Care Blog - June 12, 2023 Category: Consumer Health News Authors: Ryan Bose-Roy Tags: Health Policy Ceci Connolly MA for Tomorrow Medicare Advantage Michael Bagel Source Type: blogs
CADDAC ’S ADHD And Substance Use Disorder Peer-Led Support Groups
This is great news by CADDAC and Health Canada to create ADHD and substance use disorder peer-led support groups in the fall. They’re looking now for peer support facilitators now with lived experience who are willing to be trained and run them. Will be offered a stipend for their time.
Hope people with ADHD ask their MLAs to get provincial health departments to create ADHD and substance use disorder (SUD) peer-led support groups too.
ADHD people are 4-8 times + more likely to have SUD. Provinces should also require ALL rehabs to screen for ADHD.
Every BC rehab I’ve asked at community events in Vancouver does n...
Source: Adult ADD Strengths - June 10, 2023 Category: Psychiatry Authors: Pete Quily Tags: ADD / ADHD Addictions Source Type: blogs
Medicare Is Not Taxing or Coercing Merck, Just Reducing Its Government Subsidies
Michael F. CannonPharmaceutical giant Merck issuing Medicare, claiming new drug ‐pricing reforms that Congress enacted in last year’sInflation Reduction Act coerce the company into selling its wares to the program at below ‐market prices. In theWall Street Journal,attorney Daniel Troyopines that the new rules violate the First and Fifth Amendments. Big, if true.What ’s really happening here is that Merck is making tons of money off the taxpayers and wants to keep the gravy train rolling. So the company is offering whatever bad arguments it can to prevent any reductions in its Medicare subsidies.First, a few...
Source: Cato-at-liberty - June 9, 2023 Category: American Health Authors: Michael F. Cannon Source Type: blogs
ONC ’s HTI-1 Places Undue Burdens on Healthcare Providers, Health IT Developers
The following is a guest article by David Bucciferro, Chair of the EHR Association
In April 2023, the Office of the National Coordinator for Health Information Technology (ONC) released its much-anticipated proposed rule to advance interoperability, improve transparency, and support further access, exchange, and use of electronic health information (EHI). While the EHR Association has long supported the goals of the proposed rule, called Health Data, Technology, and Interoperability: Certification Program Updates, Algorithm Transparency, and Information Sharing Proposed Rule (HTI-1), we have a number of real concerns about...
Source: EMR and HIPAA - June 7, 2023 Category: Information Technology Authors: Guest Author Tags: Clinical EMR-EHR Health IT Company Healthcare IT Regulations Advanced Interoperability CDI Centers for Medicare and Medicaid Services Clinical Decision Support CMS David Bucciferro Decision Support Interventions DSI eHI EHR Ass Source Type: blogs
Healthcare Innovation Funding – Regulations and Disrupting Traditional Models
We are at an exciting time in the world of healthcare! With technology becoming more accessible and more and more digital natives entering the work force, there’s an abundance of innovation. We have so many more people that are coming up with creative digital solutions to the challenges that we are currently facing. However, while there are plenty of great ideas and startups, there’s just simply not enough money to fund all of them.
So how do you make sure that you’re the one getting the funding you need and not another startup? Oftentimes, the answer lies within making yourself stand out, and a great wa...
Source: EMR and HIPAA - June 2, 2023 Category: Information Technology Authors: John Lynn Tags: C-Suite Leadership Health IT Company Healthcare IT Regulations Bill Charnetski Ceteri Capital Debiopharm Derek Streat DexCare Frederico Ferreira Braga Healthcare Disruption Healthcare Innovation Funding Jay Ackerman Microsoft P Source Type: blogs
Fast Facts about Discretionary Spending
Romina Boccia and Dominik LettThe federal government will spend $6.3 trillion in 2023, 27 percent is discretionary and 73 percent is mandatory. Discretionary spending refers to federal programs that receive funding through annual appropriations. Less than half ofdiscretionary spending is for defense. More than half isfor nondefense activitiesincludingeducation, infrastructure, scientific research, and other programs.If Congress does not pass annual appropriations bills before October 1st (the beginning of the federal fiscal year), the government undergoes a partial “shutdown” where non‐essential functions are ha...
Source: Cato-at-liberty - May 30, 2023 Category: American Health Authors: Romina Boccia, Dominik Lett Source Type: blogs
The world is flat
This article also mentions the chemtrails absurdity.Climate change denial and chemtrails go back a long way, basically since right wing politics in the U.S. and Europe went batshit crazy. They obviously didn ' t like the Affordable Care Act, but the reasons they said they didn ' t like it were hallucinatory.Remember Sarah Palin and " death panels "?The America I know and love is not one in which my parents or my baby
with Down Syndrome will have to stand in front of Obama ' s ' death panel '
so his bureaucrats can decide, based on a subjective judgment of their ' level of productivity in society. 'That was a total ...
Source: Stayin' Alive - May 27, 2023 Category: American Health Source Type: blogs
What Can We Learn from the Envision Bankruptcy?
This study ignited a firestorm of press criticism and was followed by an aggressive lobbying and PR campaign funded by United and other large commercial payers aimed at restricting balance billing by firms like Envision.
This campaign culminated in the Dec 2020 Congressional passage of the No Surprises Act, which effectively ended balance billing and subjected thousands of Envision’s out-of-network bills to an arbitration process. NSA went into effect in January 2022. Ironically, days prior to its Chapter 11 filing, Envision won a $91 million judgment from an arbitration panel against United fo...
Source: The Health Care Blog - May 24, 2023 Category: Consumer Health News Authors: matthew holt Tags: The Business of Health Care Envision HCA Jeff Goldsmith Private equity Sound Physicians Tenet United HealthGroup Source Type: blogs
Asking Bard And ChatGPT To Find The Best Medical Care, I Got Truth And Truthiness
BY MICHAEL MILLENSON
If you ask ChatGPT how many procedures a certain surgeon does or a specific hospital’s infection rate, the OpenAI and Microsoft chatbot inevitably replies with some version of, “I don’t do that.”
But depending upon how you ask, Google’s Bard provides a very different response, even recommending a “consultation” with particular clinicians.
Bard told me how many knee replacement surgeries were performed by major Chicago hospitals in 2021, their infection rates and the national average. It even told me which Chicago surgeon does the most knee surgeries and his infection rate. When I...
Source: The Health Care Blog - May 22, 2023 Category: Consumer Health News Authors: Ryan Bose-Roy Tags: Health Tech Uncategorized Bard ChatGPT Michael Millenson OpenAPI Source Type: blogs
Family physicians unite at the U.S. Capitol, seeking congressional support for Medicare reform and health care transformation
Picture this: Hundreds of family physicians and future family physicians arriving on the steps of the U.S. Capitol to share the top challenges they face and to ask their leaders to make a purposeful investment in primary care. They’ve earned the right to make this request through the hard work, long hours, and comprehensive care
Read more…
Family physicians unite at the U.S. Capitol, seeking congressional support for Medicare reform and health care transformation originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - May 22, 2023 Category: General Medicine Authors: Tochi Iroku-Malize, MD, MPH, MBA, Sterling N. Ransone, Jr., MD, Tags: Policy Primary Care Public Health & Policy Source Type: blogs
From Debt Ceiling Crisis to Debt Crisis
Romina BocciaThe U.S. government teeters on the brink of defaulting on its payment obligations over the next few weeks as the debt limit threatens to bind in early June. There ’s been extensivecoverage about the potential for catastrophic impacts on the economy if Congress and the President do not raise the debt ceiling. What ’s missing from the debate is serious consideration of the potentially catastrophic longer‐term scenario the United States could face if spending and debt continue growing unabated.Current debt limit discussions are indicative of the myopia that characterizes the federal budget process. A d...
Source: Cato-at-liberty - May 22, 2023 Category: American Health Authors: Romina Boccia Source Type: blogs
MultiPlan Acquires Leading Healthcare Data and Analytics Firm Benefits Science LLC
Ushers in a New Era of the Company, Accelerates Launch of New Data & Decision Science Service Line with a World-Class Data & Analytics Platform and Team at BST
MultiPlan Corporation (MultiPlan or the Company), a leading provider of technology and data-enabled cost management, payment, and revenue integrity solutions to the U.S. healthcare industry, today announced that it has acquired Benefits Science LLC (Benefits Science Technologies or BST), a next generation data and advanced analytics company that combines modern data science, including machine learning and artificial intelligence (AI), with deep expertise i...
Source: EMR and HIPAA - May 18, 2023 Category: Information Technology Authors: Healthcare IT News Tags: Health IT Company Healthcare IT AI Artificial Intelligence Benefits Science LLC Benefits Science Technologies BenInsights BofA Securities Inc. BST Dale White Data & Decision Science Data & Decision Science Service Line Dimitris Ber Source Type: blogs
Matthew ’s health care tidbits: Health care pricing is cray-zee
Each time I send out the THCB Reader, our newsletter that summarizes the best of THCB (Sign up here!) I include a brief tidbits section. Then I had the brainwave to add them to the blog. They’re short and usually not too sweet! –Matthew Holt
It’s no secret that health care pricing has been out of whack for a very long time. This past week PBMs and pharma manufacturers were in front of congressional committees trying to defend the indefensible–how much drugs cost and why? Hospitals have been required to publish their fictional price lists (their chargemasters) for a few years now and more recently have been instr...
Source: The Health Care Blog - May 16, 2023 Category: Consumer Health News Authors: matthew holt Tags: Health Policy Matthew Holt Carbon Health Elevance PBMs pricing TrTansparency Source Type: blogs
Centene Corporation Signs Definitive Agreement to Divest Apixio to New Mountain Capital
Centene Corporation announced today that it has signed a definitive agreement to sell Apixio, a leading artificial intelligence platform that enables value-based care, to New Mountain Capital, a growth-oriented investment firm with more than $37 billion in assets under management. Centene acquired Apixio in December 2020.
Apixio improves administrative, clinical and financial outcomes for some of the nation’s leading health plans and provider groups using its proprietary clinical data curation and artificial intelligence engine. With a patented data science infrastructure, Apixio analyzes structured and unstructure...
Source: EMR and HIPAA - May 15, 2023 Category: Information Technology Authors: Healthcare IT News Tags: Health IT Company Healthcare IT AI Apixio Bass Berry & Sims PLC Centene Centene Corporation Clinical Data Health IT Acquisitions Healthcare M&A J.P. Morgan Securities LLC Matt Holt New Mountain Capital Ropes & Gray LLP Sarah M. Source Type: blogs
Repeal the Debt Ceiling
This article appeared onSubStack on May 12, 2023.Unless Congress cuts spending or raises taxes in the near future, the federal government will hit its debt ceiling later this summer. At that point the United States will either default or pursue “extraordinary measures,” such as minting a trillion dollarcoin.President Biden wants a “clean” increase in the ceiling; Republicans want a substantial cut in spending in exchange for raising the limit. In all likelihood, the two sides will appear to make no progress until the last second before default; they will then jointly announce a compromise that both sides portray...
Source: Cato-at-liberty - May 12, 2023 Category: American Health Authors: Jeffrey Miron Source Type: blogs
