Dexcom Spends Big on Super Bowl Ad to Hype New G7 Claiming " Feels Like Magic " ; But Formulary Exclusions Aren't Magic
This month was the U.S. NFL ' s Super Bowl #57; the two teams which played one another were the Philadelphia Eagles and the Kansas City (Missouri) Chiefs, and the Kansas City Chiefs were the winners in a close game throughout. For a moment, let ' s just overlook that Kansas City ' s team name is rooted in the same racism against indigenous native Americans (after all, the team ' s logo is an arrowhead, which was created by native Americans) the same view ultimately forced the old Washington Redskins to change the team name to the Washington Commanders), and let ' s instead focus on this year ' s game advertising. Whil...
Source: Scott's Web Log - February 18, 2023 Category: Endocrinology Tags: Business of Diabetes 2023 Abbott Advertising business strategy CGM CGMS Dexcom Freestyle Libre Super Bowl Source Type: blogs
The Right Way to Address the Debt Limit
Jeffrey MironWith an impending showdown of the federal debt limit looming, neither Republicans nor Democrats are addressing the only real way to reign in debt and keep the U.S. fiscally solvent. In a New York Sun column today, I tell lawmakers a difficult truth:The United States currentlylimits the federal debt to $31.4 trillion. Borrowing hit this limit on January 19, but the government will notdefault until at least July due to various “extraordinary measures.” If default occurs, a major financial crisis is likely. How should the United States respond?By cutting Social Security and Medicare.The Un...
Source: Cato-at-liberty - February 17, 2023 Category: American Health Authors: Jeffrey Miron Source Type: blogs
Retrieving Billions in Overpayments by CMS
This article focuses on the relatively young technologies that enable CMS to uncover overbillings, whether they be errors or fraud. The article is based on an interview with Kel Pults, chief clinical officer and vice president of MediQuant. A future article will explain how Medicare Advantage plans are trying to improving data collection and reporting, and how AI helps.
Challenges of Investigating Overpayments
Undeserved payments are needles lurking in the haystack of 135 million Americans enrolled in Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). But the needles pile up fast. Improper payments f...
Source: EMR and HIPAA - February 17, 2023 Category: Information Technology Authors: Andy Oram Tags: AI/Machine Learning Analytics/Big Data Health IT Company Healthcare IT Regulations Revenue Cycle Management #COVID19 CMS COVID Reimbursement Healthcare AI Healthcare Analytics Kel Pults MAOs Medicare Advantage MediQuant Overp Source Type: blogs
All Three Legs of the Obamacare Stool Are Working Well – Part 2
BY GEORGE HALVORSON
2022 Medicare Advantage data gathering process change made last year just made upcoding for plans irrelevant and impossible, but the critics do not accept that it happened.
CMS just ended that upcoding debate for 2022 by completely killing the coding system for the plans, effective immediately. The plans can’t code risk levels up because the coding system was eliminated entirely for 2022.
RAPS is dead.
The payment approach for Medicare Advantage now has no upcoding components and the government just used their new and more accurate numbers to create the 2023 payment level for the pla...
Source: The Health Care Blog - February 17, 2023 Category: Consumer Health News Authors: Ryan Bose-Roy Tags: Health Policy Affordable Care Act Medicaid Medicare Medicare Advantage Obamacare Source Type: blogs
Don ’ t fall for the Medicare Advantage hype: the realities of coverage for low-income enrollees [PODCAST]
Subscribe to The Podcast by KevinMD. Catch up on old episodes! We’re joined by Aniyizhai Annamalai, an internal medicine-psychiatry physician. Dr. Annamalai’s patients are mostly indigent, not employed due to disability, and have serious mental illnesses. Most of them qualify for Medicaid. In this episode, Dr. Annamalai shares her insights on Medicare Advantage plans and
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Don’t fall for the Medicare Advantage hype: the realities of coverage for low-income enrollees [PODCAST] originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - February 17, 2023 Category: General Medicine Authors: The Podcast by KevinMD Tags: Podcast Medicare Source Type: blogs
Let ’s Finish The Job
BY MIKE MAGEE
In President Biden’s State of the Union Address, the most oft repeated phrase was “Let’s Finish The Job!” This came as part of an appeal for partnership as well as an assertion that in his first two years as President much had been accomplished.
Several days later, as if on cue, U.S. Senator Amy Klobuchar (D-MN) and Senator Chuck Grassley (R-IA), joint chairs of the Senate Subcommittee on Competition Policy, Antitrust, and Consumer Rights, announced that two bipartisan pieces of legislation focused on reducing the price of drugs to consumers had passed the Senate Judiciary Committee.
Both bil...
Source: The Health Care Blog - February 16, 2023 Category: Consumer Health News Authors: Ryan Bose-Roy Tags: Health Policy Affordable Generics and Biosimilars Act Biden Mike Magee state of the union Source Type: blogs
CBO on Medicare and Social Security
Chris EdwardsNew Congressional Budget Officeprojections show that federal budget deficits will rise from $1.41 trillion in 2023 to $2.85 trillion by 2033. In 2023, federal spending of $6.22 trillion is 29 percent higher than federal taxes of $4.81 trillion. By 2033, projected spending of $9.95 trillion would be 40 percent higher than taxes of $7.10 trillion. Deficits are projected to explode even though Republican tax cuts are set to expire after 2025.Without budget reforms, accumulated federal debt held by the public will almost double from $26 trillion in 2023 to $46 trillion by 2033. That vast expansion in debt willunde...
Source: Cato-at-liberty - February 15, 2023 Category: American Health Authors: Chris Edwards Source Type: blogs
The CBO Budget and Economic Outlook in the Post ‐COVID Fiscal Era
Romina Boccia and Dominik LettThe Congressional Budget Office (CBO) just released its latestBudget and Economic Outlook for 2023 to 2033, providing 10 ‐year fiscal projections for the post‐COVID fiscal era. The United States is on the tail‐end of an unprecedented surge in emergency spending during which inflation hit a 40‐year record high. To control this surge in inflation, the Federal Reserve adopted a tighter monetary stan ce by increasing interest rates. In this context, CBO’s report forecasts a worsening fiscal trajectory characterized by high and rising federal debt. Pandemic spending followe...
Source: Cato-at-liberty - February 15, 2023 Category: American Health Authors: Romina Boccia, Dominik Lett Source Type: blogs
All Three Legs of the Obamacare Stool Are Working Well
BY GEORGE HALVORSON
When the Affordable Care Act was passed, the politics were so intense and the debates were so filled with rhetoric in all directions that most people actually didn’t understand that there were three major component parts to the strategy and program that function very directly as a package, and should be looked at now in the context of several years of implementation to see how each part of that law is currently doing.
Medicaid was our first priority.
The first component part — and the one that had the highest need for passage when the law was passed because we were doing such a horrible job...
Source: The Health Care Blog - February 15, 2023 Category: Consumer Health News Authors: Ryan Bose-Roy Tags: Health Policy Affordable Care Act George Halvorson Medicaid Medicare Medicare Advantage Source Type: blogs
#HealthPolicyValentines – Happy Valentine ’ s Day
Happy Valentine’s Day everyone! If you’re on Twitter, then you probably know that today many in the healthcare world are sharing what they call #HealthPolicyValentines. You can see the latest feed of tweets here. This is a humorous and informative way to talk about some of the nuances of healthcare and specifically healthcare policy. We decided to celebrate the holiday, that we’d share a few of the best ones we saw below. We hope you enjoy and get a good laugh.
Health policy wonks logging onto Twitter to check #HealthPolicyValentines this morning pic.twitter.com/X0gsFT1wau
— Dania Palanker (@...
Source: EMR and HIPAA - February 14, 2023 Category: Information Technology Authors: John Lynn Tags: Healthcare IT Regulations #healthpolicyvalentines Personal Musings Valentine's Day Source Type: blogs
Bonus Features – February 12, 2023 – Epic tops Best in KLAS for 13th straight year, 89% of healthcare finance leaders remain confident in 2023, and more
This article will be a weekly roundup of interesting stories, product announcements, new hires, partnerships, research studies, awards, sales, and more. Because there’s so much happening out there in healthcare IT we aren’t able to cover in our full articles, we still want to make sure you’re informed of all the latest news, announcements, and stories happening to help you better do your job.
News
The Biden Administration announced the latest initiatives in the reignited Cancer Moonshot program. One initiative of interest to the healthcare IT community is CancerX, a public-private innovation partnership to develop to...
Source: EMR and HIPAA - February 12, 2023 Category: Information Technology Authors: Brian Eastwood Tags: Healthcare IT AdvancedMD Alloantibody Exchange Beacon Health System Best in KLAS Biden Biofourmis Brooke Bowers Cancer Moonshot CareCloud CHG Healthcare CIvitas Clean Air CMS Complete Care David Feinberg DexCare DrFirst Source Type: blogs
Breaking the glass ceiling in medicine: the struggles and strengths of female doctors
There’s some pretty good evidence out there that women physicians provide really good medical care—in some cases, better than their male counterparts. For instance, a 2017 study showed that hospitalized Medicare patients under the care of a female doctor had lower rates of 30-day mortality and readmission to the hospital than those cared for by
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Breaking the glass ceiling in medicine: the struggles and strengths of female doctors originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - February 10, 2023 Category: General Medicine Authors: Rosalind Kaplan, MD Tags: Physician Hospital-Based Medicine Primary Care Source Type: blogs
THCB Gang Episode 115, Thursday February 9
Joining Matthew Holt (@boltyboy) on #THCBGang on Thursday February 9 at 1PM PT 4PM ET were futurist Ian Morrison (@seccurve); medical historian Mike Magee (@drmikemagee); patient safety expert and all around wit Michael Millenson (@mlmillenson); and delivery & platform expert Vince Kuraitis (@VinceKuraitis). There was the usual chat and a lot of conversation about the future of Medicare, Medicare Advantage and the CVS acquisition of Oak Street.
You can see the video below & if you’d rather listen than watch, the audio is preserved as a weekly podcast available on our iTunes & Spotify c...
Source: The Health Care Blog - February 9, 2023 Category: Consumer Health News Authors: Abdul Ghafar Tags: THCB Gang Ian Morrison Matthew Holt Michael Millenson Mike Magee Vince Kuraitis Source Type: blogs
Mark Cuban Cost Plus Drug Company ( " MCCPDC " ) PBC May Be Able to Say " Mission Accomplished " Even if Sales Stop Growing
On January 19, 2022, a startup called theMark Cuban Cost Plus Drug Company ( " MCCPDC " )opened its doors to the American public as a new online pharmacy and generic manufacturing startup. Initially, MCCPDC was also planning to launch its own Pharmacy Benefit Manager, but it later scrapped those plans, instead announcing several PBM partnerships with some PBM startups which do not engage in " spread pricing " , including on generic, biosimilar and " authorized generic " drugs. The company bears the name of its famous principal investor, multibillionaire Mark Cuban, who is perhaps best known as both owner of the NBA te...
Source: Scott's Web Log - February 7, 2023 Category: Endocrinology Tags: authorized generic 2023 Alex Oshmyansky authorized generics Biosimilar biosimilars Cost Plus costplus drug company drug prices drug pricing generic drugs mark cuban Mark Cuban Cost Plus Drug Company Source Type: blogs
Pearl Health Raises $75M Series B Led by a16z to Accelerate Growth and Innovation in Value-Based Care
Pearl Health (Pearl), a leading technology company focused on physician enablement and risk bearing in value-based care, today announced that it has raised $75 million in its oversubscribed Series B funding round, led by Andreessen Horowitz (a16z)‘s Growth Fund and Viking Global Investors, with participation by AlleyCorp, SV Angel‘s Growth Fund, and other leading investors. The round is comprised of $55 million in equity capital and an anticipated $20 million in a line of credit, and brings Pearl’s total funding to date to more than $100M.
“We are grateful to have the support of such esteemed...
Source: EMR and HIPAA - February 6, 2023 Category: Information Technology Authors: Healthcare IT News Tags: Health IT Company Healthcare IT a16z a16z's Growth Fund AlleyCorp Andreessen Horowitz Andreessen Horowitz's Growth Fund Health IT Funding Health IT Fundings Health IT Investment Jeffrey De Flavio MD Kevin Ryan Michael Kopko Pearl Source Type: blogs
